Active NPI
Sung Ho Bae, MD
- Neurology Physician
- Newark, DE
National Provider Identifier
1396795076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- C1-0001851
- Practice address
- 774 Christiana Rd
Suite 201
Newark, DE 19713-4236 - Phone
- (302) 731-3017
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | C1-0001851 | DE | Primary |
Addresses
Primary practice location
774 Christiana Rd
Suite 201
Newark, DE 19713-4236
Mailing address
774 Christiana Rd
Suite 201
Newark, DE 19713-4236
Phone (302) 731-3017
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126601 | Medicaid | DE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1-0001851 | DE | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurology Associates, PA | Neurology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369872000000",
"number": "1396795076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "774 CHRISTIANA RD",
"address_2": "SUITE 201",
"city": "NEWARK",
"state": "DE",
"postal_code": "197134236",
"telephone_number": "302-731-3017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "774 CHRISTIANA RD",
"address_2": "SUITE 201",
"city": "NEWARK",
"state": "DE",
"postal_code": "197134236",
"telephone_number": "302-731-3017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAE",
"first_name": "SUNG",
"middle_name": "HO",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2013-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "DE",
"license": "C1-0001851",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "126601",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.