Individual provider Active NPI

Edmund T Delguercio, MD

  • Nephrology Physician
  • Darby, PA
National Provider Identifier
1598744815
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD008725E Issued in PA
Practice address
1501 Lansdowne Ave
Ste 201
Darby, PA 19023-1333
Phone
(610) 534-6230
Fax
(610) 534-6166
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD008725E PA
Nephrology Physician 207RN0300X MD008725E PA Primary

Addresses

Primary practice location

1501 Lansdowne Ave
Ste 201
Darby, PA 19023-1333

Mailing address

1501 Lansdowne Ave
Ste 201
Darby, PA 19023-1333
Phone (610) 534-6230

Other identifiers 1

IdentifierTypeStateIssuer
0006487040001MedicaidPA

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
MD008725EPAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Medical Associates, LTD Nephrology Past Accepting new patients
Clinical Renal Associates, LLC Nephrology PastSince May 1, 2016 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3389/brand/1/csg/21/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1598744815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 LANSDOWNE AVE",
            "address_2": "STE 201",
            "city": "DARBY",
            "state": "PA",
            "postal_code": "190231333",
            "telephone_number": "610-534-6230",
            "fax_number": "610-534-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 LANSDOWNE AVE",
            "address_2": "STE 201",
            "city": "DARBY",
            "state": "PA",
            "postal_code": "190231333",
            "telephone_number": "610-534-6230",
            "fax_number": "610-534-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGUERCIO",
        "first_name": "EDMUND",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD008725E",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD008725E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006487040001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Darby, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; 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.