Individual provider Active NPI

Robert Scott Becker, PAC

  • Physician Assistant
  • Salisbury, MD
National Provider Identifier
1336217082
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0002004 Issued in MD
Practice address
1675 Woodbrooke Drive
Salisbury, MD 21804
Phone
(410) 749-4154
NPI assigned
Dec 1, 2006
Last updated
Sep 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0002004 MD Primary
Physician Assistant 363A00000X C5-0000686 DE

Addresses

Primary practice location

1675 Woodbrooke Drive
Salisbury, MD 21804

Mailing address

PO Box 69709
Baltimore, MD 21264-9709
Phone (410) 749-4154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100726000424 DE Practitioner - Physician Assistant 1557493632 Reassigns benefits to 2 organizations
I20101111000639 MD Practitioner - Physician Assistant 1557493632 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of New York at Stony Brook, School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians
Peninsula Orthopaedic Assoc PAGroup PAC ID 6406844406, 56 clinicians

Practice addresses (Care Compare)

100 E Carroll St
Salisbury, MD 21801-5422

1675 Woodbrooke Dr
Salisbury, MD 21804-8502
Phone (410) 749-4154

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Orthopaedic Assoc, PA Physician Assistant CurrentSince Jul 1, 1998 Accepting new patients
Peninsula Orthopaedic Assoc PA CurrentSince Jul 1, 1998 Accepting new patients
Peninsula Orthopaedic Assoc., PA CurrentSince May 11, 2010 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

30265 Commerce Dr
Unit 104
Millsboro, DE 19966
Phone (302) 629-4787

503 Health Services Dr
Seaford, DE 19973

314 Franklin Ave
Ste 502
Berlin, MD 21811
Phone (410) 641-0202

11107 Cathage Rd
Unit 101
Ocean Pines, MD 21811
Phone (410) 641-0202

1675 Woodbrooke Dr
Salisbury, MD 21804
Phone (410) 701-3327

Organizations & group practices 6

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 2

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1336217082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69709",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212649709",
            "telephone_number": "410-749-4154",
            "fax_number": "410-749-9583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 WOODBROOKE DRIVE",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "21804",
            "telephone_number": "410-749-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "ROBERT",
        "middle_name": "SCOTT",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002004",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0000686",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.