Active NPI
Satoshi Ikeda MD PA
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Elkton, MD
National Provider Identifier
1306034160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- C100000901
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 170001 | Medicaid | MD |
National Provider Directory
National Provider DirectoryLocations
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.