Individual provider Active NPI

Jill Rachel Mermagen, PA-C

  • Surgical Physician Assistant
  • Newark, DE
National Provider Identifier
1285856716
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
4755 Stanton Ogletown Road
Newark, DE 19711
Phone
(302) 733-2666
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X DE Primary

Addresses

Primary practice location

4755 Stanton Ogletown Road
Newark, DE 19711

Mailing address

3536 Green Spring Road
Havre de Graace, MD 21078-1111
Phone (410) 734-4039

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
I20160408001752 DE Practitioner - Physician Assistant 1355649260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc Surgical CurrentSince Mar 14, 2016 Accepting new patients
Christiana Care Health Services Inc CurrentSince Mar 14, 2016 Accepting new patients

Locations

4755 Ogletown Stanton Rd
Ste 2670
Newark, DE 19718
Phone (302) 584-2601

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

4701 Ogletown Stanton Rd
Ste 1500
Newark, DE 19713
Phone (302) 623-4343

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

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 and National Provider Directory roles.

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285856716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 GREEN SPRING ROAD",
            "city": "HAVRE DE GRAACE",
            "state": "MD",
            "postal_code": "210781111",
            "telephone_number": "410-734-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 STANTON OGLETOWN ROAD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19711",
            "telephone_number": "302-733-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERMAGEN",
        "first_name": "JILL",
        "middle_name": "RACHEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "DE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.