Individual provider Active NPI

Laxmichand Dedhia, M.D.

  • Family Medicine Physician
  • Middletown, DE
National Provider Identifier
1508845132
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C10004403 Issued in DE
Practice address
114 Sandhill Dr
Ste 101
Middletown, DE 19709-5805
Phone
(302) 378-4779
Fax
(302) 378-4789
NPI assigned
Jan 12, 2006
Last updated
Jul 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C10004403 DE Primary

Addresses

Primary practice location

114 Sandhill Dr
Ste 101
Middletown, DE 19709-5805

Mailing address

114 Sandhill Dr
Ste 101
Middletown, DE 19709-5805
Phone (302) 378-4779

Other identifiers 2

IdentifierTypeStateIssuer
C10004403OtherDEDE STATE LICENCE NO.
0000587501MedicaidDE

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
I20110531000339 DE Practitioner - Family Practice 4587563028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middletown Familycare Associates LLCGroup PAC ID 3779482211, 2 clinicians

Practice addresses (Care Compare)

114 Sandhill Dr
Suite 101
Middletown, DE 19709-5805
Phone (302) 378-4779

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.95 of 100Reported as apm
Quality
81.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C10004403DEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middletown Familycare Associates LLC Family Medicine CurrentSince Jun 1, 1999 Accepting new patients
First State Family Practice, Inc Family Medicine Past Accepting new patients

Locations

114 Sandhill Dr
Ste 101
Middletown, DE 19709
Phone (302) 378-4779

Organizations & group practices 2

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 2

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1508845132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 SANDHILL DR",
            "address_2": "STE 101",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197095805",
            "telephone_number": "302-378-4779",
            "fax_number": "302-378-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 SANDHILL DR",
            "address_2": "STE 101",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197095805",
            "telephone_number": "302-378-4779",
            "fax_number": "302-378-4789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDHIA",
        "first_name": "LAXMICHAND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C10004403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DE STATE LICENCE NO.",
            "identifier": "C10004403",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000587501",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, DE

Sources for this page

Verify at the official NPI Registry.