Organization Active NPI

Satoshi Ikeda MD PA

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Elkton, MD
National Provider Identifier
1306034160
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
C100000901 Issued in DE
Legal business name
SATOSHI IKEDA MD PA
Practice address
111 W High St
Suite 211
Elkton, MD 21921-5529
Phone
(410) 392-3033
Fax
(410) 392-2897
NPI assigned
Oct 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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

Authorized official

Name
Dr. Satoshi Ikeda, M.D.
Title
Doctor
Phone
(410) 392-3033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X C100000901 DE Primary

Addresses

Primary practice location

111 W High St
Suite 211
Elkton, MD 21921-5529

Mailing address

71 Omega Dr
Building D
Newark, DE 19713-2063
Phone (302) 283-3300

Other identifiers 1

IdentifierTypeStateIssuer
170001MedicaidMD

National Provider Directory

National Provider Directory

Locations

71D Omega Dr
Newark, DE 19713

2300 Pennsylvania Ave
Ste 3D
Wilmington, DE 19806
Phone (302) 656-3333

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224806400000",
    "number": "1306034160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 OMEGA DR",
            "address_2": "BUILDING D",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132063",
            "telephone_number": "302-283-3300",
            "fax_number": "302-283-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W HIGH ST",
            "address_2": "SUITE 211",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215529",
            "telephone_number": "410-392-3033",
            "fax_number": "410-392-2897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SATOSHI IKEDA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2008-10-24",
        "status": "A",
        "authorized_official_last_name": "IKEDA",
        "authorized_official_first_name": "SATOSHI",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "410-392-3033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "DE",
            "license": "C100000901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.