Individual provider Active NPI

Kenneth Trzepkowski, M.D.

  • Family Medicine Physician
  • Newark, DE
National Provider Identifier
1699736140
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C1-0011654 Issued in DE
Practice address
4755 Ogletown Stanton Rd
Suite 6E34
Newark, DE 19718-2200
Phone
(302) 733-4186
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036625 GA
Family Medicine Physician 207Q00000X C1-0011654 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd
Suite 6E34
Newark, DE 19718-2200

Mailing address

4755 Ogletown Stanton Rd
Suite 6E34
Newark, DE 19718-2200
Phone (302) 733-4186

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
I20160622000434 DE Practitioner - Hospice/Palliative CarePractitioner - Family Practice 2860681996 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0011654DEMDFamily Medicine Physician
036625GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc CurrentSince Jul 5, 2016 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services Inc CurrentSince Jul 5, 2016 Accepting new patients
Seasons Medical Group of Delaware, P.a CurrentSince Oct 3, 2018 Accepting new patients

Locations

200 Hygeia Dr
Newark, DE 19713
Phone (302) 273-1701

220 Continental Dr
Ste 407
Newark, DE 19713
Phone (302) 533-3800

4755 Ogletown Stanton Rd
Ste 6E34
Newark, DE 19718
Phone (302) 733-4186

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

Organizations & group practices 4

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1699736140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "address_2": "SUITE 6E34",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-4186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "address_2": "SUITE 6E34",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-4186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRZEPKOWSKI",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "036625",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C1-0011654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.