Individual provider Active NPI

Eman Mazloum, MD

  • Family Medicine Physician
  • Seaford, DE
National Provider Identifier
1265848980
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C1-0012625 Issued in DE
Practice address
100 Rawlins Dr
Seaford, DE 19973-5881
Phone
(302) 990-3300
NPI assigned
Jul 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036143373 IL
Family Medicine Physician 207Q00000X C1-0012625 DE Primary

Addresses

Primary practice location

100 Rawlins Dr
Seaford, DE 19973-5881

Mailing address

1836 South Macarthur Boulevard
Springfield, IL 62704
Phone (217) 789-1403

Other identifiers 1

IdentifierTypeStateIssuer
207Q00000XMedicaidDE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181005001162 DE Practitioner - Family Practice 9739490293 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beebe Physician Network Inc.Group PAC ID 5496744864, 301 clinicians

Practice addresses (Care Compare)

18947 John J Williams Hwy
Unit 303
Rehoboth Beach, DE 19971-4477
Phone (302) 644-0690

Hospital & facility affiliations

  • Aveanna Home Healthcare Home health agency, Milford, DE, CCN 087039
  • Beebe Hospital Home Health Home health agency, Millsboro, DE, CCN 087023
  • Bayada Home Health Care at Bayhealth Home health agency, Dover, DE, CCN 087024
  • Beebe Medical Center Hospital, Lewes, DE, CCN 080007
  • Tidalhealth Nanticoke, Inc. Hospital, Seaford, DE, CCN 080006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C1-0012625DEMDFamily Medicine Physician
036143373ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beebe Physician Network Inc. CurrentSince Dec 24, 2022 Accepting new patients
State of Delaware-Stockley CurrentSince Dec 24, 2022 Accepting new patients
Tidalhealth Physician Network, Inc. Family Medicine CurrentSince Oct 8, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

32550 Docs Pl
Unit 2
Millville, DE 19967
Phone (302) 539-4302

18947 John J Williams Hwy
Unit 303
Rehoboth Beach, DE 19971
Phone (302) 644-0690

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

100 Rawlins Dr
Seaford, DE 19973
Phone (302) 536-5415

Interoperability endpoints

  • Direct secure messaging: emazloum22713@beebehealth.direct-ci.com

Organizations & group practices 4

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 5

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": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1265848980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH MACARTHUR BOULEVARD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62704",
            "telephone_number": "217-789-1403",
            "fax_number": "217-789-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RAWLINS DR",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199735881",
            "telephone_number": "302-990-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZLOUM",
        "first_name": "EMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036143373",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C1-0012625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207Q00000X",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaford, DE

Sources for this page

Verify at the official NPI Registry.