Regional Medical Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

REGIONAL MEDICAL GROUP LLC

Practice address

4512 Kirkwood Hwy
Ste 202
Wilmington, DE 19808-5123

Phone

(302) 993-7890

Fax

(302) 993-7894

NPI assigned

Oct 24, 2012

Last updated

Mar 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susan A Cassidy

Title

Administrator

Phone

(302) 993-7890

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: regionalmedicalgroupllc@myezyaccess.com

Practitioners 34

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.

• Susan L Chudzik, CRNP

  • Family Nurse Practitioner
  • Newark, DE
  • NPI 1063415651
  Medicare reassignment Care Compare group NPD
• Laura Jean Manfield, DO

  • Family Medicine Physician
  • Wilmington, DE
  • NPI 1982720538
  Medicare reassignment Care Compare group NPD
• Andra Mirela Popescu, MD

  • Cardiovascular Disease Physician
  • Wilmington, DE
  • NPI 1952519118

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Hannah Elizabeth Trout, FNP-BC

  • Family Medicine Physician
  • Wilmington, DE
  • NPI 1578387098
  Medicare reassignment Care Compare group NPD
• Carla N. Miller, FNP

  • Nurse Practitioner
  • Millsboro, DE
  • NPI 1992137731
  Medicare reassignment NPD
• Roger Charles Stevenson, M.D

  • Internal Medicine Physician
  • Wilmington, DE
  • NPI 1396776803
  NPD
• Kunal Pikoo Bhagat, MD

  • Internal Medicine Physician
  • Newark, DE
  • NPI 1023080520
  NPD (past)
• Curt D Blacklock, DO

  • Internal Medicine Physician
  • Newark, DE
  • NPI 1467465450
  NPD (past)
• Hung Quang Dam, M.D.

  • Nuclear Medicine Physician
  • Newark, DE
  • NPI 1053374181
  NPD (past)
• James E Damour, M.D.

  • Internal Medicine Physician
  • Wilmington, DE
  • NPI 1700884061
  NPD (past)
• S. Barry Diznoff, MD

  • Diagnostic Radiology Physician
  • Hockessin, DE
  • NPI 1649239427
  NPD (past)
• Alan Evantash, MD

  • Diagnostic Radiology Physician
  • Newark, DE
  • NPI 1730149873
  NPD (past)

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1891048179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4512 KIRKWOOD HWY STE 202",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085122",
            "telephone_number": "302-999-0137",
            "fax_number": "302-999-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4512 KIRKWOOD HWY",
            "address_2": "STE 202",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085123",
            "telephone_number": "302-993-7890",
            "fax_number": "302-993-7894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-24",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "CASSIDY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "302-993-7890"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "regionalmedicalgroupllc@myezyaccess.com",
            "affiliation": "N",
            "endpointDescription": "direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4512 Kirkwood Hwy",
            "address_2": "Ste 202",
            "city": "Wilmington",
            "state": "DE",
            "country_code": "US",
            "postal_code": "198085123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Juewuo Arthur Quest Reeves, DC
• Nannette Reeves, LMT
• Jesus C Regala III, PT
• Adrienne Laura Regan, DO
• Regency Healthcare & Rehab Center LLC.
• Regional Orthopaedic Associates (Delaware Orthopaedic Specialists)
• Regional Orthopaedic Associates PA (Delaware Orthopaedic Specialists)
• Regional Orthopaedic Associates PA (Delaware Orthopaedic Specialists)
• Regional Orthopaedic Associates PA (Delaware Orthopaedic Specialists)
• Regional Orthopaedic Associates PA (Delaware Orthopaedic Specialists)

• Family Medicine Physician in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Family Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.