Khalil F Gorgui, M.D.

Individual provider Active NPI Internal Medicine Physician · Delmar, DE

NPI 1225076375 · NPPES record last updated Feb 21, 2017

Key facts

NPI
1225076375
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
C1-0004569 (DE)
Practice address
8 E Grove St
Delmar, DE 19940-1115
Phone
(302) 846-0618
Fax
(302) 846-3668
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidalhealth Physician Network, Inc. (115 clinicians)

Practice addresses (Care Compare)

Seaford, DE 19973
Phone 30262966118802

38552 Sussex Hwy
Suite 101
Delmar, DE 19940-3596
Phone (302) 846-0618

Hospital & facility affiliations

  • Tidalhealth Home Care Home health agency · Laurel, DE · CCN 087036
  • Tidalhealth Home Care Home health agency · Salisbury, MD · CCN 217079
  • Amedisys Home Health Home health agency · Georgetown, DE · CCN 087034
  • Aveanna Home Healthcare Home health agency · Milford, DE · CCN 087039
  • Tidalhealth Nanticoke, Inc. Hospital · Seaford, DE · CCN 080006
  • Tidalhealth Peninsula Regional, Inc Hospital · Salisbury, MD · CCN 210019
  • Beebe Medical Center Hospital · Lewes, DE · CCN 080007

Medicare participation

Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040304000310 DE Practitioner - Family Practice 6800783606 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C1-0004569DEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Physician Network, Inc. Current
since Jan 4, 2016
Accepting new patients
Tidalhealth Specialty Care, LLC Past Accepting new patients

Locations

8 E Grove St
Delmar, DE 19940
Phone (302) 846-0618

38552 Sussex Hwy
#101
Delmar, DE 19940
Phone (302) 297-2583

38552 Sussex Hwy
Delmar, DE 19940
Phone (302) 846-0618

801 Middleford Rd
Seaford, DE 19973
Phone (302) 628-9178

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C1-0004569 DE Yes

Addresses

Primary practice location

8 E Grove St
Delmar, DE 19940-1115

Mailing address

8 E Grove St
Delmar, DE 19940-1115
Phone (302) 846-0618

Other identifiers

IdentifierTypeStateIssuer
0000631201MedicaidDE

Other providers in Delmar, DE

All providers in Delmar, DE · Internal Medicine Physician in Delaware

Sources for this page

Verify at the official NPI Registry.