Individual provider Active NPI

Gerald M O'Brien, MD

  • Pulmonary Disease Physician
  • Newark, DE
National Provider Identifier
1215980313
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
C10006061 Issued in DE
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

Updated by the provider on Sep 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0906208002OtherCIGNA
290754OtherMAMSI
1356478OtherINDEPENDENCE BCBS
0000685101MedicaidDE
60959301OtherMDCAREFIRST BCBS
0000658101MedicaidDE
105619OtherCOVENTRY
2049044000OtherAMERIHEALTH/KEYSTONE
4618046OtherAETNA/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

LicenseStateTypeSpecialty
C10006061DEMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.