NPIMap

Organization Active NPI

Delta Medical Associates, LLC

  • Adult Health Nurse Practitioner
  • Bradenton, FL
National Provider Identifier
1902281264
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP9338988 Issued in FL
Legal business name
DELTA MEDICAL ASSOCIATES, LLC
Practice address
4606 62ND Ave E
Bradenton, FL 34203-6306
Phone
(856) 287-1775
NPI assigned
Jul 28, 2015
Last updated
Jul 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Authorized official

Name
Dennis Demaria
Title
Owner
Phone
(856) 287-1775

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP9338988 FL Primary
Internal Medicine Physician 207R00000X ME116794 FL

Addresses

Primary practice location

4606 62ND Ave E
Bradenton, FL 34203-6306

Mailing address

4606 62ND Ave E
Bradenton, FL 34203-6306
Phone (856) 287-1775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150916002231 FL Part B Supplier - Clinic/Group Practice 5890002331 Receives reassigned benefits from 11 practitioners
Practice locations: Sarasota, FL; Venice, FL; Punta Gorda, FL; Bradenton, FL; Arcadia, FL

National Provider Directory

National Provider Directory

Locations

5857 N Honore Ave
Poets Walk Alf
Sarasota, FL 34243
Phone (941) 584-5575

Practitioners & affiliated clinicians

Practitioners 12

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": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1902281264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4606 62ND AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342036306",
            "telephone_number": "856-287-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 62ND AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342036306",
            "telephone_number": "856-287-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "DEMARIA",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-287-1775"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9338988",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME116794",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.