Individual provider Active NPI

Herve Peacemaker Ineza, DO, MBA

  • Internal Medicine Physician
  • Milford, DE
National Provider Identifier
1902691397
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C7-0018858 Issued in DE
Practice address
804 N Dupont Blvd
Milford, DE 19963-1006
Phone
(302) 725-3557
NPI assigned
Apr 14, 2025
Last updated
Apr 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C7-0018858 DE Primary

Addresses

Primary practice location

804 N Dupont Blvd
Milford, DE 19963-1006

Mailing address

640 S State St
Dover, DE 19901-3530

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
I20250509003099 DE Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6002333242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Business Administration

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1902691397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 N DUPONT BLVD",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199631006",
            "telephone_number": "302-725-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INEZA",
        "first_name": "HERVE PEACEMAKER",
        "credential": "DO, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C7-0018858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, DE

Sources for this page

Verify at the official NPI Registry.