Individual provider Active NPI

Michael Vincent, MD.

  • Ophthalmology Physician
  • Wilmington, DE
National Provider Identifier
1700994209
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
C10002069 Issued in DE
Practice address
1711 Woodlawn Ave
Wilmington, DE 19806-2455
Phone
(302) 656-3319
NPI assigned
Aug 26, 2006
Sex
Male
Sole proprietor
Yes

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
Ophthalmology Physician 207W00000X C10002069 DE Primary

Addresses

Primary practice location

1711 Woodlawn Ave
Wilmington, DE 19806-2455

Mailing address

1711 Woodlawn Ave
Wilmington, DE 19806-2455
Phone (302) 656-3319

Other identifiers 4

IdentifierTypeStateIssuer
26320OtherDECOVENTRY
2042344OtherDEAETNA
514OtherMID-ATLANTIC HEALTH SYSTE
0081114000OtherAMERIHEALTH HMO

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
I20091216000078 DE Practitioner - Ophthalmology 2961574900 Reassigns benefits to 1 organization
Practice locations: Wilmington, DE

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Jefferson Medical College of Thomas Jefferson University, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

501 W 14TH St
Wilmington, DE 19801-1013

501 W 14TH St FL
6 CCHS Infectious Disease
Wilmington, DE 19801-1013
Phone (302) 320-1300

501 W 14TH St Wilmington Hospital
Wilmington, DE 19801-1013

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc CurrentSince Aug 1, 2000 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services Inc Ophthalmology CurrentSince Aug 1, 2000 Accepting new patients

Locations

501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411

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

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700994209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 WOODLAWN AVE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198062455",
            "telephone_number": "302-656-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 WOODLAWN AVE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198062455",
            "telephone_number": "302-656-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "DE",
            "license": "C10002069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "26320",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2042344",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MID-ATLANTIC HEALTH SYSTE",
            "identifier": "514",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HMO",
            "identifier": "0081114000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.