Active NPI
Mary Virginia Iacocca, MD
- Anatomic Pathology & Clinical Pathology Physician
- Newark, DE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- C10006014
- Practice address
- 4755 Ogletown Stanton Rd
Newark, DE 19718-6001 - Phone
- (302) 454-9830
- Fax
- (302) 454-1445
- NPI assigned
- Jun 21, 2005
- Last updated
- Mar 9, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | C10006014 | DE | Primary |
Addresses
Primary practice location
4755 Ogletown Stanton Rd
Newark, DE 19718-6001
Mailing address
PO Box 12210
Wilmington, DE 19850-2210
Phone (302) 454-9830
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- Virginia Commonwealth University, School of Medicine, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Christiana Care Health Services Inc
Practice addresses (Care Compare)
4701 Ogletown Stanton Rd
Suite 4200
Newark, DE 19713-2075
Phone (302) 737-7700
4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-1000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C10006014 | DE | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christiana Care Health Services, Inc | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
| Christiana Care Health Services, Inc | Current | Accepting new patients | |
| Christiana Care Health Services Inc | Current | Accepting new patients | |
| Christiana Care Health Services, Inc | Current | Accepting new patients |
Locations
200 Hygeia Dr
Newark, DE 19713
Phone (302) 273-1701
4701 Ogletown Stanton Rd
Ste 4200
Newark, DE 19713
Phone (302) 658-7533
4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700
1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440
501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411
Organizations & group practices 5
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.
-
dba CCHS Pathology
- Anatomic Pathology Physician
- Newark, DE
- NPI 1245674993
Anatomic Pathology & Clinical Pathology
-
dba CCHS Pmri
- Endocrinology, Diabetes & Metabolism Physician
- Wilmington, DE
- NPI 1770568107
-
- Internal Medicine Physician
- Elkton, MD
- NPI 1124067848
-
dba CCHS Specialty Services
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Newark, DE
- NPI 1982778270
-
dba CCHS Concord - Neurology
- Neurology Physician
- Chadds Ford, PA
- NPI 1881228484
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Christiana Care
- General Acute Care Hospital
- Wilmington, DE
- NPI 1134194038
-
- General Acute Care Hospital
- Elkton, MD
- NPI 1376523357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299628800000",
"number": "1689670119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12210",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198502210",
"telephone_number": "302-454-9830",
"fax_number": "302-454-1445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4755 OGLETOWN STANTON RD",
"city": "NEWARK",
"state": "DE",
"postal_code": "197186001",
"telephone_number": "302-454-9830",
"fax_number": "302-454-1445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IACOCCA",
"first_name": "MARY",
"middle_name": "VIRGINIA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-21",
"last_updated": "2011-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "DE",
"license": "C10006014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.