NPIMap

Organization Active NPI

Christiana Spine Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Newark, DE
National Provider Identifier
1275774747
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
PENDING Issued in DE
Legal business name
CHRISTIANA SPINE AMBULATORY SURGICAL CENTER, LLC
Practice address
1101 Twin C Lane
Suite 102
Newark, DE 19713
Phone
(302) 602-7000
Fax
(302) 602-7012
NPI assigned
Mar 13, 2009
Last updated
Nov 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Authorized official

Name
Tony R Cucuzzella, M.D.
Title
Medical Director
Phone
(302) 602-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X PENDING DE Primary

Addresses

Primary practice location

1101 Twin C Lane
Suite 102
Newark, DE 19713

Mailing address

4735 Ogletown Stanton Rd
Suite 3302
Newark, DE 19713-2072
Phone (302) 602-7000

Other identifiers 1

IdentifierTypeStateIssuer
1457480535OtherDENPI #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090710000072 DE Part B Supplier - Ambulatory Surgical Center 9830241553 Receives reassigned benefits from 3 practitioners
Practice locations: Newark, DE

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Christiana Spine Ambulatory Surgical Center LLCCCN 08C0001029
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1101 Twin C Ln
Ste 102
Newark, DE 19713
Phone (302) 602-7000

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1275774747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN STANTON RD",
            "address_2": "SUITE 3302",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132072",
            "telephone_number": "302-602-7000",
            "fax_number": "302-602-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 TWIN C LANE",
            "address_2": "SUITE 102",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-602-7000",
            "fax_number": "302-602-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIANA SPINE AMBULATORY SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-13",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "CUCUZZELLA",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "302-602-7000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "DE",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI #",
            "identifier": "1457480535",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.