Organization Active NPI

Patricia D Lifrak MD Inc

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • New Castle, DE
National Provider Identifier
1295744191
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
C10003713 Issued in DE
Legal business name
PATRICIA D LIFRAK MD INC
Practice address
287 Christiana Rd
Suite 8
New Castle, DE 19720-2978
Phone
(302) 328-4392
Fax
(302) 689-0122
NPI assigned
Aug 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Authorized official

Name
Patricia D Lifrak, MDNPI 1780691915
Title
President
Phone
(302) 328-4392

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084A0401X C10003713 DE Primary
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084A0401X C1-0003713 DE

Addresses

Primary practice location

287 Christiana Rd
Suite 8
New Castle, DE 19720-2978

Mailing address

5 Yorkridge Trail
Hockessin, DE 19707
Phone (302) 328-4392

Other identifiers 2

IdentifierTypeStateIssuer
1000021561MedicaidDE
P00367274OtherRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061114000118 DE Part B Supplier - Clinic/Group Practice 9032117791 Receives reassigned benefits from 1 practitioner
Practice locations: Georgetown, DE; New Castle, DE

National Provider Directory

National Provider Directory

Locations

600 E Market St
Georgetown, DE 19947
Phone (302) 328-4392

287 Christiana Rd
Ste 6
New Castle, DE 19720
Phone (302) 328-4392

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1295744191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 YORKRIDGE TRAIL",
            "city": "HOCKESSIN",
            "state": "DE",
            "postal_code": "19707",
            "telephone_number": "302-328-4392",
            "fax_number": "302-689-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 CHRISTIANA RD",
            "address_2": "SUITE 8",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197202978",
            "telephone_number": "302-328-4392",
            "fax_number": "302-689-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA D LIFRAK MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "LIFRAK",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-328-4392",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "DE",
            "license": "C10003713",
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "DE",
            "license": "C1-0003713",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000021561",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00367274",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Castle, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.