Individual provider Active NPI

Robert Lee Witt, MD

  • Otolaryngology Physician
  • Newark, DE
National Provider Identifier
1659342582
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
C10002706 Issued in DE
Practice address
4745 Ogletown Stanton Rd
Suite 112
Newark, DE 19713-2067
Phone
(302) 738-6014
Fax
(302) 738-6017
NPI assigned
Jan 30, 2006
Last updated
May 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X C10002706 DE Primary

Addresses

Primary practice location

4745 Ogletown Stanton Rd
Suite 112
Newark, DE 19713-2067

Mailing address

4745 Ogletown Stanton Rd
Suite 112
Newark, DE 19713-2067
Phone (302) 738-6014

Other identifiers 1

IdentifierTypeStateIssuer
0000080302MedicaidDE

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
I20051017000842 DE Practitioner - Otolaryngology 3072539345

National Provider Directory

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1659342582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 OGLETOWN STANTON RD",
            "address_2": "SUITE 112",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132067",
            "telephone_number": "302-738-6014",
            "fax_number": "302-738-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 OGLETOWN STANTON RD",
            "address_2": "SUITE 112",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132067",
            "telephone_number": "302-738-6014",
            "fax_number": "302-738-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "ROBERT",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "DE",
            "license": "C10002706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000080302",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.