Southern Delaware Medical Group, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C20006015 Issued in DE

Legal business name

SOUTHERN DELAWARE MEDICAL GROUP, PA

Practice address

100 Silicato Pkwy Ste 301
Milford, DE 19963-1272

Phone

(302) 725-2040

Fax

(855) 403-0778

NPI assigned

Jul 18, 2006

Last updated

Sep 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Olga Samary Gonzalez

Title

Practice Manager

Phone

(302) 725-2040

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cedric Terriell Barnes, D.O.

  • Family Medicine Physician
  • Milford, DE
  • NPI 1851338040
  Medicare reassignment Care Compare group NPD
• Scott A. Hammer, M.D.

  • Family Medicine Physician
  • Milford, DE
  • NPI 1679557722
  Medicare reassignment Care Compare group NPD
• Zeeshan Ahmad, MD

  • Physical Medicine & Rehabilitation Physician
  • Urbana, IL
  • NPI 1134126451
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1386662054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199630337",
            "telephone_number": "302-725-2040",
            "fax_number": "855-403-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SILICATO PKWY STE 301",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199631272",
            "telephone_number": "302-725-2040",
            "fax_number": "855-403-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DELAWARE MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2021-09-16",
        "certification_date": "2021-07-07",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "OLGA",
        "authorized_official_middle_name": "SAMARY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "302-725-2040"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C20006015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rohab Sohail, MD
• Solid Healthcare Practice Solutions (Family Health in Delaware)
• Sophia Solomon, BS, CPRS
• Sandra Sommerfield
• Cassaundra Souk
• Southern Delaware Sports Care and Rehabilitation, LLC
• Joseph E Spigone
• John Spillane, OTR
• Riley Stallone
• Anastasiya Stapleton

• Family Medicine Physician in Milford, DE
• Providers in Milford, DE by specialty
• Family Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.