Active NPI
Kyle Vaitukaitis
- Pharmacist
- Rehoboth Beach, DE
National Provider Identifier
1295288645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 24206
- Practice address
- 19869 Sea Blossom Blvd
Rehoboth Beach, DE 19971-7142 - Phone
- (302) 226-7791
- NPI assigned
- Aug 2, 2016
- Last updated
- Aug 2, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | A1-0004965 | DE | |
| Pharmacist | 183500000X | 24206 | MD | Primary |
Addresses
Primary practice location
19869 Sea Blossom Blvd
Rehoboth Beach, DE 19971-7142
Mailing address
10620 Pine Needle Rd
Ocean City, MD 21842-4838
Phone (410) 982-7300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A1-0004965 | DE | MD | Pharmacist |
| 24206 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delaware CVS Pharmacy LLC | Past | Accepting new patients | |
| Delaware CVS Pharmacy, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470096000000",
"number": "1295288645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10620 PINE NEEDLE RD",
"city": "OCEAN CITY",
"state": "MD",
"postal_code": "218424838",
"telephone_number": "410-982-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19869 SEA BLOSSOM BLVD",
"city": "REHOBOTH BEACH",
"state": "DE",
"postal_code": "199717142",
"telephone_number": "302-226-7791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAITUKAITIS",
"first_name": "KYLE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-02",
"last_updated": "2016-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "DE",
"license": "A1-0004965",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "24206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rehoboth Beach, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.