Individual provider Active NPI

Matthew T Caddell, D.O.

  • Family Medicine Physician
  • Milford, DE
National Provider Identifier
1407874019
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C2-0023888 Issued in DE
Practice address
800 N Dupont Blvd
Milford, DE 19963-1019
Phone
(302) 672-2319
Fax
(302) 430-5448
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 218076 NY
Occupational Medicine Physician 2083X0100X 218076-1 NY
Family Medicine Physician 207Q00000X C2-0023888 DE Primary

Addresses

Primary practice location

800 N Dupont Blvd
Milford, DE 19963-1019

Mailing address

800 N Dupont Blvd
Milford, DE 19963-1019
Phone (302) 672-2319

Other practice location 1

1873 Western Avenue
Suite 100
Albany, NY 12203
Phone (518) 690-4420

Other identifiers 4

IdentifierTypeStateIssuer
02444484MedicaidNY
5016G1OtherNYEMPIRE BC.BS
7132503OtherNYAETNA
1T6630OtherDEMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210902000885 DE Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 2163418591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
University of New England, College of Osteo Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayhealth Medical Center, IncGroup PAC ID 1658364740, 399 clinicians

Practice addresses (Care Compare)

800 N Dupont Blvd
Walkin Medical Care
Milford, DE 19963-1019
Phone (302) 430-5705

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218076NYMDPreventive Medicine/Occupational Environmental Medicine Physician
218076-1NYMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc CurrentSince Oct 20, 2021 Accepting new patients
Bayhealth Medical Center, Inc. CurrentSince Oct 20, 2021 Accepting new patients
Inspira Health Network Medical Group, P.C. Past Accepting new patients

Locations

665 S Bay Rd
Unit C
Dover, DE 19901
Phone (302) 672-2319

800 N DuPont Blvd
Milford, DE 19963
Phone (302) 422-3000

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 1

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1407874019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N DUPONT BLVD",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199631019",
            "telephone_number": "302-672-2319",
            "fax_number": "302-430-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N DUPONT BLVD",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199631019",
            "telephone_number": "302-672-2319",
            "fax_number": "302-430-5448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1873 Western Avenue",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "12203",
            "country_code": "US",
            "telephone_number": "518-690-4420",
            "fax_number": "518-690-4427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CADDELL",
        "first_name": "MATTHEW",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NY",
            "license": "218076",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NY",
            "license": "218076-1",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C2-0023888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02444484",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC.BS",
            "identifier": "5016G1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7132503",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "1T6630",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, DE

Sources for this page

Verify at the official NPI Registry.