NPIMap

Organization Active NPI

First State Orthopaedics PA

  • Orthopaedic Surgery Physician
  • Smyrna, DE
National Provider Identifier
1336356328
Registry record updated Aug 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
FIRST STATE ORTHOPAEDICS PA
Practice address
100 S Main St Ste 300
Smyrna, DE 19977-1495
Phone
(302) 731-2888
Fax
(302) 731-7049
NPI assigned
May 17, 2007
Last updated
Aug 25, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2017

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

Authorized official

Name
David Blaeuer
Title
Administrator
Phone
(302) 731-2888

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 562752 DE
Orthopaedic Surgery Physician 207X00000X DE Primary

Addresses

Primary practice location

100 S Main St Ste 300
Smyrna, DE 19977-1495

Mailing address

211 Executive Dr
Suite 11
Newark, DE 19702-3358
Phone (302) 731-2888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930094465 DE DME Supplier - Multi-Specialty - Physician 6103800057 Practice locations: Smyrna, DE

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503619200000",
    "number": "1336356328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 EXECUTIVE DR",
            "address_2": "SUITE 11",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023358",
            "telephone_number": "302-731-2888",
            "fax_number": "302-731-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S MAIN ST STE 300",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "199771495",
            "telephone_number": "302-731-2888",
            "fax_number": "302-731-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST STATE ORTHOPAEDICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2017-08-25",
        "status": "A",
        "authorized_official_last_name": "BLAEUER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "302-731-2888"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "DE",
            "license": "562752",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "DE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2017; 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.