NPIMap

Organization Active NPI

Bayhealth Medical Center, Inc

Doing business as Bayhealth Neurosurgery, Kent Campus

  • Neurological Surgery Physician
  • Dover, DE
National Provider Identifier
1184181992
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
BAYHEALTH MEDICAL CENTER, INC
Doing business as
Bayhealth Neurosurgery, Kent Campus
Practice address
540 S Governors Ave Ste 100
Dover, DE 19904-3530
Phone
(302) 744-7000
Fax
(302) 744-7181
NPI assigned
Feb 28, 2019
Last updated
Feb 28, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Tretina
Title
Sr. Vice President/ Cfo
Phone
(302) 744-7162

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X Primary
Neurology Physician 2084N0400X

Addresses

Primary practice location

540 S Governors Ave Ste 100
Dover, DE 19904-3530

Mailing address

640 S State St
Dover, DE 19901-3530
Phone (302) 744-7162

Other names 1

  • Bayhealth Neurosurgery, Kent Campus Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001600 DE Part B Supplier - Clinic/Group Practice 1658364740 Receives reassigned benefits from 228 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dover, DE; Milford, DE

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551312000000",
    "number": "1184181992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-744-7162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 S GOVERNORS AVE STE 100",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199043530",
            "telephone_number": "302-744-7000",
            "fax_number": "302-744-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYHEALTH MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-28",
        "last_updated": "2019-02-28",
        "status": "A",
        "authorized_official_last_name": "TRETINA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT/ CFO",
        "authorized_official_telephone_number": "302-744-7162"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayhealth Neurosurgery, Kent Campus",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bayhealth Neurosurgery, Kent Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.