Individual provider Active NPI

Timothy O'Donnell, MD

  • Internal Medicine Physician
  • Newark, DE
National Provider Identifier
1770502809
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
CI0003058 Issued in DE
Practice address
Suite 32 Peoples Plaza
Newark, DE 19702
Phone
(302) 834-6800
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0033510 MD
Internal Medicine Physician 207R00000X CI0003058 DE Primary

Addresses

Primary practice location

Suite 32 Peoples Plaza
Newark, DE 19702

Mailing address

322 East Cecil Avenue
Suite 2
North East, MD 21901
Phone (410) 287-3727

Other identifiers 1

IdentifierTypeStateIssuer
0000229701MedicaidDE

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
I20101101001440 DE Practitioner - Internal Medicine 4183702129 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CI0003058DEMDInternal Medicine Physician
D0033510MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc Internal Medicine CurrentSince Sep 21, 2020 Accepting new patients
Christiana Care Health Services Inc CurrentSince Sep 21, 2020 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients

Locations

726 Yorklyn Rd
Ste 100
Hockessin, DE 19707
Phone (302) 234-5770

313 W Main St
Newark, DE 19711
Phone (302) 731-4620

313 W Main St
Ste A
Newark, DE 19711
Phone (302) 731-4620

32 Peoples Plz
Newark, DE 19702
Phone (302) 834-6800

300 Biddle Ave
Ste 200
Newark, DE 19702
Phone (302) 838-4750

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770502809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 EAST CECIL AVENUE",
            "address_2": "SUITE 2",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "21901",
            "telephone_number": "410-287-3727",
            "fax_number": "410-287-2819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUITE 32 PEOPLES PLAZA",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19702",
            "telephone_number": "302-834-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "TIMOTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0033510",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "CI0003058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000229701",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.