Individual provider Active NPI

Dallas L Mastin, FNP-BC FNP-C

  • Family Nurse Practitioner
  • Milford, DE
National Provider Identifier
1255929022
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0011570 Issued in DE
Practice address
100 Wellness Way
Milford, DE 19963-4364
Phone
(302) 943-3637
NPI assigned
Jan 6, 2021
Last updated
Aug 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LG-0011570 DE Primary
Registered Nurse 163W00000X L1-0043517 DE

Addresses

Primary practice location

100 Wellness Way
Milford, DE 19963-4364

Mailing address

100 Wellness Way
Milford, DE 19963-4364
Phone (302) 943-3637

Other practice location 1

209 Beaufort Ln
Milford, DE 19963-3781
Phone (302) 943-3637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210408002798 DE Practitioner - Nurse Practitioner 0749698850 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group Delaware IncGroup PAC ID 9638312572, 94 clinicians

Practice addresses (Care Compare)

100 Wellness Way
Milford, DE 19963-4364
Phone (302) 430-5175

640 S State St
Dover, DE 19901-3530
Phone (302) 674-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.66 of 100Reported as group
Quality
81.55
Improvement activities
40
Cost
75.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
L1-0043517DEMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Integrative Healthcare, LLC CurrentSince Apr 9, 2021 Accepting new patients
Delaware Integrative Healthcare LLC Family CurrentSince Apr 9, 2021 Accepting new patients
Apogee Medical Group, Delaware, Inc CurrentSince Sep 1, 2021 Accepting new patients
Delaware Integrative Healthcare of Milford, LLC CurrentSince Apr 9, 2021 Accepting new patients
Middletown Chiropractic and Rehabilitation, Inc. PastSince Dec 12, 2016 Accepting new patients

Locations

640 S State St
Dover, DE 19901
Phone (302) 744-4700

401 E Main St
Ste 4B
Middletown, DE 19709
Phone (302) 376-5830

421 E Main St
Ste 6
Middletown, DE 19709
Phone (302) 376-5830

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

600 N DuPont Blvd
Unit 686
Milford, DE 19963
Phone (302) 376-5830

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1255929022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WELLNESS WAY",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199634364",
            "telephone_number": "302-943-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WELLNESS WAY",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199634364",
            "telephone_number": "302-943-3637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 Beaufort Ln",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "DE",
            "postal_code": "199633781",
            "country_code": "US",
            "telephone_number": "302-943-3637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTIN",
        "first_name": "DALLAS",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "FNP-BC FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0011570",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0043517",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, DE

Sources for this page

Verify at the official NPI Registry.