Individual provider Active NPI

Justin Fleegle, PA-C

  • Surgical Physician Assistant
  • Newark, DE
National Provider Identifier
1477029353
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C5-0001271 Issued in DE
Practice address
774 Christiana Road
Suite 202
Newark, DE 19713
Phone
(302) 366-7671
Fax
(302) 366-7549
NPI assigned
Oct 18, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X C5-0001271 DE Primary

Addresses

Primary practice location

774 Christiana Road
Suite 202
Newark, DE 19713

Mailing address

774 Christiana Road
Suite 202
Newark, DE 19713
Phone (302) 366-7671

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181213000419 DE Practitioner - Physician Assistant 0941545388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delaware Neurosurgical Group, PAGroup PAC ID 1557300431, 24 clinicians

Practice addresses (Care Compare)

774 Christiana Rd
Suite 202
Newark, DE 19713-4221
Phone (302) 366-7671

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001
  • Beebe Medical Center Hospital, Lewes, DE, CCN 080007
  • Bayhealth Medical Center, Kent Campus Hospital, Dover, DE, CCN 080004
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179

Merit-based Incentive Payment System (MIPS)

Final score
66.27 of 100Reported as individual
Quality
41.67
Promoting interoperability
79
Improvement activities
40
Cost
63.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C5-0001271DEMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: justin.fleegle@deneurosurgical.directbygreenway.com

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.

Hospital & facility affiliations 4

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": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1477029353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 CHRISTIANA ROAD",
            "address_2": "SUITE 202",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-366-7671",
            "fax_number": "302-366-7549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 CHRISTIANA ROAD",
            "address_2": "SUITE 202",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-366-7671",
            "fax_number": "302-366-7549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEEGLE",
        "first_name": "JUSTIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-18",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "DE",
            "license": "C5-0001271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.