Individual provider Active NPI

Peter M Witherell, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Wilmington, DE
National Provider Identifier
1598790099
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
C1-0004878 Issued in DE
Practice address
3411 Silverside Road
Suite 103 Rodney Building
Wilmington, DE 19810
Phone
(302) 478-7001
Fax
(302) 478-7002
NPI assigned
Jul 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X C1-0004878 DE Primary

Addresses

Primary practice location

3411 Silverside Road
Suite 103 Rodney Building
Wilmington, DE 19810

Mailing address

PO Box 3012
Wilmington, DE 19804
Phone (302) 224-5678

Other identifiers 1

IdentifierTypeStateIssuer
0000752101MedicaidDE

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
I20070328000422 DE Practitioner - Interventional Pain ManagementPractitioner - AnesthesiologyPractitioner - Pain Management 0143272070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Anesthesiology
Education
Jefferson Medical College of Thomas Jefferson University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interventional Spine Pain Consultants PAGroup PAC ID 2567487150, 5 clinicians

Practice addresses (Care Compare)

774 Christiana Rd
Suite 111
Newark, DE 19713-4248
Phone (302) 478-7001

774 Christiana Rd
Suite 202
Newark, DE 19713-4221
Phone (302) 478-7001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.38 of 100Reported as individual
Quality
79.85
Improvement activities
40
Cost
78.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0004878DEMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Spine Pain Consultants, PA CurrentSince Apr 1, 2003 Accepting new patients
Anesthesia Services PA Past Accepting new patients
Casscells Orthopaedics and Sports Medicine, PA Past Accepting new patients

Locations

774 Christiana Rd
Ste 111
Newark, DE 19713
Phone (302) 478-7001

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

3411 Silverside Rd
Ste 103
Wilmington, DE 19810
Phone (302) 479-8464

Interoperability endpoints

  • Direct secure messaging: interventionalspinepainconsultantspa.peterwitherell@146264.advancedmd-direct.com

Organizations & group practices 3

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598790099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3012",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19804",
            "telephone_number": "302-224-5678",
            "fax_number": "302-224-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 SILVERSIDE ROAD",
            "address_2": "SUITE 103 RODNEY BUILDING",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19810",
            "telephone_number": "302-478-7001",
            "fax_number": "302-478-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERELL",
        "first_name": "PETER",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "DE",
            "license": "C1-0004878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000752101",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.