Individual provider Active NPI

Brian T Nam, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Newark, DE
National Provider Identifier
1275509937
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
C1-0010222 Issued in DE
Practice address
4701 Ogletown Stanton Road
Suite 2100
Newark, DE 19713
Phone
(302) 623-4530
Fax
(302) 623-4578
NPI assigned
Feb 23, 2006
Last updated
Dec 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 54904-20 WI
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X C1-0010222 DE Primary

Addresses

Primary practice location

4701 Ogletown Stanton Road
Suite 2100
Newark, DE 19713

Mailing address

PO Box 30170
Wilmington, DE 19805-7170

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
I20130114000104 DE Practitioner - Thoracic SurgeryPractitioner - General Surgery 5193744571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: General Surgery
Education
University of Wisconsin School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

1401 Foulk Rd
Wilmington, DE 19803-2764

4701 Ogletown Stanton Rd
Newark, DE 19713-2055
Phone (302) 623-3605

4701 Ogletown Stanton Rd
Suite 1307
Newark, DE 19713-2079
Phone (302) 623-4601

4701 Ogletown Stanton Rd
Suite 2100
Newark, DE 19713-7000
Phone (302) 623-4960

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

501 W 14TH St
Wilmington, DE 19801-1013

501 W 14TH St FL
6 CCHS Infectious Disease
Wilmington, DE 19801-1013
Phone (302) 320-1300

501 W 14TH St Wilmington Hospital
Wilmington, DE 19801-1013

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54904-20WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Nov 1, 2012 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services Inc CurrentSince Nov 1, 2012 Accepting new patients
Christiana Care Health Services, Inc Past Accepting new patients
Christiana Care Health Services, Inc. Past Accepting new patients

Locations

4701 Ogletown Stanton Rd
Newark, DE 19713
Phone (302) 266-7800

4701 Ogletown Stanton Rd
Ste 2100
Newark, DE 19713
Phone (302) 623-4530

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

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 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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1275509937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30170",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198057170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 OGLETOWN STANTON ROAD",
            "address_2": "SUITE 2100",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-623-4530",
            "fax_number": "302-623-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "BRIAN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "54904-20",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "DE",
            "license": "C1-0010222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.