Individual provider Active NPI

Prosper Tarley, PA-C

  • Physician Assistant
  • Lewes, DE
National Provider Identifier
1265248314
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
12100 Black Swan Dr Ste 201
Lewes, DE 19958-4991
Phone
(302) 644-3311
Fax
(302) 644-3300
NPI assigned
Dec 4, 2024
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X DE Primary

Addresses

Primary practice location

12100 Black Swan Dr Ste 201
Lewes, DE 19958-4991

Mailing address

33117 Turquoise LN Unit 5103
Rehoboth Beach, DE 19971-7161
Phone (267) 838-8661

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
I20250304000768 DE Practitioner - Physician Assistant 7618498957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First State Orthopaedics PAGroup PAC ID 6103800057, 97 clinicians

Practice addresses (Care Compare)

12100 Black Swan Dr
Suite 201
Lewes, DE 19958-4988
Phone (302) 644-3311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
First State Orthopaedics, PA CurrentSince Dec 13, 2024 Accepting new patients
First State Orthopaedics PA CurrentSince Dec 13, 2024 Accepting new patients
First State Orthopaedics PA Physician Assistant Past Accepting new patients

Locations

12100 Black Swan Dr
Ste 201
Lewes, DE 19958

211 Executive Dr
Ste 11
Newark, DE 19702
Phone (302) 793-1800

4745 Ogletown Stanton Rd
Ste 238
Newark, DE 19713

Interoperability endpoints

  • Direct secure messaging: prosper.tarleypac.p2@direct.fsoortho.nextgenshare.com

Organizations & group practices 3

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 2

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": "1733270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1265248314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33117 TURQUOISE LN UNIT 5103",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199717161",
            "telephone_number": "267-838-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 BLACK SWAN DR STE 201",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199584991",
            "telephone_number": "302-644-3311",
            "fax_number": "302-644-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARLEY",
        "first_name": "PROSPER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewes, DE

Sources for this page

Verify at the official NPI Registry.