Organization Active NPI

Atlantic Adult and Pediatric Medicine, PA

  • Family Medicine Physician
  • Lewes, DE
National Provider Identifier
1801958863
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ATLANTIC ADULT AND PEDIATRIC MEDICINE, PA
Practice address
34435 King Street Row Ste 1
Lewes, DE 19958-4787
Phone
(302) 644-1300
Fax
(302) 644-1086
NPI assigned
Dec 15, 2006
Last updated
Dec 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Authorized official

Name
Dr. Charles Stanislav, M.DNPI 1720067747
Title
Physician
Phone
(302) 644-1085

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

34435 King Street Row Ste 1
Lewes, DE 19958-4787

Mailing address

34435 King Street Row Ste 1
Lewes, DE 19958-4787
Phone (302) 644-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040127000359 DE Part B Supplier - Clinic/Group Practice 7911809173 Receives reassigned benefits from 4 practitioners
Practice locations: Lewes, DE

National Provider Directory

National Provider Directory

Locations

34435 King Street Row
Lewes, DE 19958
Phone (302) 644-1300

34435 King Street Row
#1
Lewes, DE 19958
Phone (302) 360-0142

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21915/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1801958863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34435 KING STREET ROW STE 1",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199584787",
            "telephone_number": "302-644-1300",
            "fax_number": "302-644-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34435 KING STREET ROW STE 1",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199584787",
            "telephone_number": "302-644-1300",
            "fax_number": "302-644-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC ADULT AND PEDIATRIC MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "STANISLAV",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "302-644-1085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewes, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.