Organization Active NPI

Mid-Atlantic Surgical Practice

  • Surgery Physician
  • Wilmington, DE
National Provider Identifier
1477007797
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MID-ATLANTIC SURGICAL PRACTICE
Practice address
1500 Shallcross Ave
Suite 1-a
Wilmington, DE 19806-3037
Phone
(302) 652-6050
Fax
(302) 652-6053
NPI assigned
Aug 4, 2016
Last updated
Aug 17, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
MID-ATLANTIC SURGICAL PRACTICEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Authorized official

Name
James Joseph Tayoun Jr., D.O.
Title
Physican
Phone
(302) 652-6050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

1500 Shallcross Ave
Suite 1-a
Wilmington, DE 19806-3037

Mailing address

PO Box 8157
Wilmington, DE 19803-8157
Phone (302) 652-6050

Other identifiers 1

IdentifierTypeStateIssuer
1000035769MedicaidDE

National Provider Directory

National Provider Directory
Part of
Mid-Atlantic Surgical Prac

Locations

1500 Shallcross Ave
Ste 1A
Wilmington, DE 19806
Phone (302) 407-2457

NPI Registry JSON

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1477007797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8157",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198038157",
            "telephone_number": "302-652-6050",
            "fax_number": "302-652-6053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SHALLCROSS AVE",
            "address_2": "SUITE 1-A",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198063037",
            "telephone_number": "302-652-6050",
            "fax_number": "302-652-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-ATLANTIC SURGICAL PRACTICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MID-ATLANTIC SURGICAL PRACTICE",
        "enumeration_date": "2016-08-04",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "TAYOUN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PHYSICAN",
        "authorized_official_telephone_number": "302-652-6050",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000035769",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.