Organization Active NPI

Nephrology Associates PA

  • Nephrology Physician
  • Newark, DE
National Provider Identifier
1407805203
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NEPHROLOGY ASSOCIATES PA
Practice address
4923 Ogletown Stanton Rd
Suite 200
Newark, DE 19713-2081
Phone
(032) 225-0451
Fax
(302) 225-0472
NPI assigned
May 9, 2006
Last updated
Oct 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Authorized official

Name
Martin F Gavin, D.O.NPI 1609862150
Title
President
Phone
(302) 225-0451

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

4923 Ogletown Stanton Rd
Suite 200
Newark, DE 19713-2081

Mailing address

4923 Ogletown Stanton Rd
Suite 200
Newark, DE 19713-2081
Phone (032) 225-0451

Other identifiers 3

IdentifierTypeStateIssuer
0000078002MedicaidDE
788161400MedicaidMD
8818401MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dfisher@delawarekidney.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD, PA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040106000439 DE Part B Supplier - Clinic/Group Practice 9830098177 Receives reassigned benefits from 66 practitioners
Practice locations: Wilmington, DE; Newark, DE; Milford, DE; Lewes, DE; Elkton, MD; Dover, DE; Middletown, DE
O20050330000391 MD Part B Supplier - Clinic/Group Practice 9830098177 Receives reassigned benefits from 27 practitioners
Practice locations: Elkton, MD
O20200123000332 PA Part B Supplier - Clinic/Group Practice 9830098177 Receives reassigned benefits from 8 practitioners
Practice locations: Chadds Ford, PA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
08D0664102Nephrology Associates PA4923 Ogletown Stantion Road Suite 200, Newark, DE 19713Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Locations

748 S New St
Ste Cd
Dover, DE 19904
Phone (302) 734-3227

20930 DuPont Blvd
Unit 101
Georgetown, DE 19947
Phone (302) 360-0142

20930 DuPont Blvd
Unit 202
Georgetown, DE 19947
Phone (302) 202-3438

1632 Savannah Rd
Ste 3
Lewes, DE 19958
Phone (302) 569-5186

104 Sleepy Hollow Dr
Ste 207
Middletown, DE 19709
Phone (302) 574-6800

124 Sleepy Hollow Dr
Ste 200
Middletown, DE 19709
Phone (302) 285-0369

200 Kings Hwy
Ste 1
Milford, DE 19963
Phone (302) 422-0800

1092 Old Churchmans Rd
Newark, DE 19713
Phone (302) 472-9880

4923 Ogletown Stanton Rd
Ste 200
Newark, DE 19713
Phone (302) 225-0451

315 N Carter Rd
Ste 315
Smyrna, DE 19977
Phone (302) 734-3227

701 N Clayton St
Ste 401
Wilmington, DE 19805
Phone (302) 225-0451

111 W High St
Ste 203
Elkton, MD 21921
Phone (410) 398-3950

111 W High St
Ste 210
Elkton, MD 21921
Phone (302) 999-0144

291 Wilmington W Chester Pike
Chadds Ford, PA 19317
Phone (484) 842-1798

291 Wilmington W Chester Pike
#P
Chadds Ford, PA 19317
Phone (484) 842-1798

Ownership & related parties

Subparts reporting this organization as parent 6

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 121

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.

View all 121

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1407805203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4923 OGLETOWN STANTON RD",
            "address_2": "SUITE 200",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132081",
            "telephone_number": "032-225-0451",
            "fax_number": "302-225-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4923 OGLETOWN STANTON RD",
            "address_2": "SUITE 200",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132081",
            "telephone_number": "032-225-0451",
            "fax_number": "302-225-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-225-0451",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000078002",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "788161400",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8818401",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dfisher@delawarekidney.com",
            "affiliation": "N",
            "endpointDescription": "fisher direct email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "4923 Ogletown Stanton Rd",
            "address_2": "Suite 200",
            "city": "Newark",
            "state": "DE",
            "country_code": "US",
            "postal_code": "197132081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 13, 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.