Nanticoke Gastroenterology, P.a.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

C10004336 Issued in DE

Legal business name

NANTICOKE GASTROENTEROLOGY, P.A.

Practice address

924 Middleford Rd
Seaford, DE 19973-3604

Phone

(302) 629-2229

Fax

(302) 629-2285

NPI assigned

Feb 8, 2007

Last updated

Mar 14, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bradley Paul Mackler, M.D.NPI 1356430854

Title

C.E.O.

Phone

(302) 629-2229

Specialties & licenses 1

Addresses

Other identifiers 11

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley Paul Mackler, M.D.

  • Gastroenterology Physician
  • Seaford, DE
  • NPI 1356430854
  Authorized official Same address or phone

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331683200000",
    "number": "1649311325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 MIDDLEFORD RD",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199733604",
            "telephone_number": "302-629-2229",
            "fax_number": "302-629-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 MIDDLEFORD RD",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199733604",
            "telephone_number": "302-629-2229",
            "fax_number": "302-629-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANTICOKE GASTROENTEROLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2012-03-14",
        "status": "A",
        "authorized_official_last_name": "MACKLER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "302-629-2229",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "DE",
            "license": "C10004336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "1939",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "2714",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPT CHOICE",
            "identifier": "421862",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000825302",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND MEDICAID",
            "identifier": "0916029 00",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "T266",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "085567809",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "505182",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDIPA",
            "identifier": "421862",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "PAL58270210001",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "100010338",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Seaford, DE
• Providers in Seaford, DE by specialty
• Gastroenterology Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; 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.