NPIMap

Individual provider Active NPI

Justin P. Eldridge, M.D.

  • Internal Medicine Physician
  • Wilmington, DE
National Provider Identifier
1295937365
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C1-0009675 Issued in DE
Practice address
501 W 14TH St
Wilmington, DE 19801-1013
Phone
(302) 320-4410
NPI assigned
Jun 1, 2007
Last updated
Nov 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X C1-0009675 DE
Pediatrics Physician 208000000X LP01077 RI
Internal Medicine Physician 207R00000X C1-0009675 DE Primary

Addresses

Primary practice location

501 W 14TH St
Wilmington, DE 19801-1013

Mailing address

200 Hygeia Dr Ste 2300
Newark, DE 19713-2049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110816000359 DE Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Pediatric MedicinePractitioner - Hospitalist 6901075548 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist, Pediatric Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2007
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, shared by 25 NPIs, 1,480 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 623-0188

501 W 14TH St
Wilmington, DE 19801-1013
Phone (302) 320-4410

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP01077RIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc Internal Medicine CurrentSince Dec 5, 2016 Accepting new patients
Christiana Care Health Services Inc Internal Medicine CurrentSince Jul 6, 2015 Accepting new patients
Christiana Care Health Services Inc CurrentSince Jul 6, 2015 Accepting new patients

Locations

200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362

4755 Ogletown Stanton Rd
Ste 5A43
Newark, DE 19718
Phone (302) 623-0188

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

501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1295937365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR STE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W 14TH ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198011013",
            "telephone_number": "302-320-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRIDGE",
        "first_name": "JUSTIN",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "DE",
            "license": "C1-0009675",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "LP01077",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0009675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.