NPIMap

Individual provider Active NPI

Wayne I Tucker, D.O, P.A.

  • Family Medicine Physician
  • Bear, DE
National Provider Identifier
1356430821
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C20004133 Issued in DE
Practice address
101 Becks Woods Dr
Suite 100
Bear, DE 19701-3854
Phone
(302) 838-1100
Fax
(302) 838-8962
NPI assigned
Oct 12, 2006
Last updated
Apr 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C20004133 DE Primary

Addresses

Primary practice location

101 Becks Woods Dr
Suite 100
Bear, DE 19701-3854

Mailing address

101 Becks Woods Dr
Suite 100
Bear, DE 19701-3854
Phone (302) 838-1100

Other identifiers 1

IdentifierTypeStateIssuer
510410516OtherDETAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120301000130 DE Practitioner - Family Practice 3476543240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York Medical College, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

101 Becks Woods Dr
Suite 100
Bear, DE 19701-3855
Phone (302) 838-1100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Physician Assistant

State licenses

LicenseStateTypeSpecialty
C20004133DEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Tucker DO, PA Family Medicine CurrentSince Sep 11, 2001 Accepting new patients
Delaware Sleep Disorder Centers, LLC PastSince Mar 1, 2011 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

100 Becks Woods Dr
Ste 202
Bear, DE 19701
Phone (302) 365-8280

101 Becks Woods Dr
Ste 100
Bear, DE 19701
Phone (302) 838-1100

Organizations & group practices 3

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 9

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1356430821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BECKS WOODS DR",
            "address_2": "SUITE 100",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197013854",
            "telephone_number": "302-838-1100",
            "fax_number": "302-838-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BECKS WOODS DR",
            "address_2": "SUITE 100",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197013854",
            "telephone_number": "302-838-1100",
            "fax_number": "302-838-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "WAYNE",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "D.O, P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C20004133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "510410516",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bear, DE

Sources for this page

Verify at the official NPI Registry.