Gina Marie Fong, MD

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

C1-0011860 Issued in DE

Practice address

1600 Rockland Rd
Wilmington, DE 19803

Phone

(302) 651-4200

Fax

(302) 651-4945

NPI assigned

Apr 5, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Gina Marie Mittelstaedt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1346583689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-4200",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19803",
            "telephone_number": "302-651-4200",
            "fax_number": "302-651-4945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4745 Ogletown Stanton Rd # Map1",
            "address_2": "Suite 217",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197132067",
            "country_code": "US",
            "telephone_number": "302-733-2168",
            "fax_number": "302-733-2602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4745 Ogletown Stanton Rd # Map1",
            "address_2": "Suite 217",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197132067",
            "country_code": "US",
            "telephone_number": "302-733-2168",
            "fax_number": "302-733-2602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONG",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-05",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "DE",
            "license": "C1-0011860",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "MITTELSTAEDT",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Justine Fogam, LMSW
• Katharine E Foley, LMT
• Ohana Aquarian Foley, CADC
• Erin Foltz, MA, BCBA
• Eveline Fondong
• Kelvin Fong, MD
• Tanner Fonjweng
• John B Fontana Jr., D.D.S.
• Steven Andrew Fontana, D.M.D.
• Richard Fontanet Jr., CCC-SLP

• Neonatal-Perinatal Medicine Physician in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Neonatal-Perinatal Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.