Active NPI
Gerald M O'Brien, MD
- Pulmonary Disease Physician
- Newark, DE
National Provider Identifier
1215980313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- C10006061
- Practice address
- 4745 Ogletown Stanton Rd
Suite 220
Newark, DE 19713-2067 - Phone
- (302) 368-5515
- Fax
- (302) 366-1240
- NPI assigned
- May 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | C10006061 | DE | Primary |
Addresses
Primary practice location
4745 Ogletown Stanton Rd
Suite 220
Newark, DE 19713-2067
Mailing address
4745 Ogletown Stanton Rd
Suite 220
Newark, DE 19713-2067
Phone (302) 368-5515
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0906208002 | Other | CIGNA | |
| 290754 | Other | MAMSI | |
| 1356478 | Other | INDEPENDENCE BCBS | |
| 0000685101 | Medicaid | DE | |
| 60959301 | Other | MD | CAREFIRST BCBS |
| 0000658101 | Medicaid | DE | |
| 105619 | Other | COVENTRY | |
| 2049044000 | Other | AMERIHEALTH/KEYSTONE | |
| 4618046 | Other | AETNA/USHC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C10006061 | DE | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pulmonary Associates P.a. | Pulmonary Disease | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pulmonary Disease Physician
- Wilmington, DE
- NPI 1750336541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283385600000",
"number": "1215980313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4745 OGLETOWN STANTON RD",
"address_2": "SUITE 220",
"city": "NEWARK",
"state": "DE",
"postal_code": "197132067",
"telephone_number": "302-368-5515",
"fax_number": "302-366-1240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4745 OGLETOWN STANTON RD",
"address_2": "SUITE 220",
"city": "NEWARK",
"state": "DE",
"postal_code": "197132067",
"telephone_number": "302-368-5515",
"fax_number": "302-366-1240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'BRIEN",
"first_name": "GERALD",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-18",
"last_updated": "2010-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "DE",
"license": "C10006061",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0906208002",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "290754",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENCE BCBS",
"identifier": "1356478",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0000685101",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BCBS",
"identifier": "60959301",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0000658101",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "105619",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH/KEYSTONE",
"identifier": "2049044000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/USHC",
"identifier": "4618046",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.