NPIMap

Individual provider Active NPI

Rebecca Anne Achterhof, MD

  • Pediatrics Physician
  • Newark, DE
National Provider Identifier
1477500742
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C10008222 Issued in DE
Practice address
2600 Glasgow Ave
Suite 213
Newark, DE 19702-4773
Phone
(302) 836-4440
Fax
(302) 836-4466
NPI assigned
May 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA07884200 NJ
General Practice Physician 208D00000X C10008222 DE
Pediatrics Physician 208000000X C10008222 DE Primary

Addresses

Primary practice location

2600 Glasgow Ave
Suite 213
Newark, DE 19702-4773

Mailing address

2600 Glasgow Ave
Suite 213
Newark, DE 19702-4773
Phone (302) 836-4440

Other identifiers 3

IdentifierTypeStateIssuer
0080853MedicaidNJ
0314048MedicaidMD
102058942MedicaidPA

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA07884200NJMDPediatrics Physician
C10008222DEMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Pediatrics, LLC Pediatrics 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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1477500742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 GLASGOW AVE",
            "address_2": "SUITE 213",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197024773",
            "telephone_number": "302-836-4440",
            "fax_number": "302-836-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GLASGOW AVE",
            "address_2": "SUITE 213",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197024773",
            "telephone_number": "302-836-4440",
            "fax_number": "302-836-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACHTERHOF",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07884200",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "DE",
            "license": "C10008222",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DE",
            "license": "C10008222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080853",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0314048",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102058942",
            "state": "PA"
        }
    ],
    "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 Nov 22, 2011; 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.