Individual provider Active NPI

Sidney J Swanson III, MD

  • Urology Physician
  • Newark, DE
National Provider Identifier
1922118462
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
C1-0008058 Issued in DE
Practice address
4735 Ogletown Stanton Rd
Suite 1204
Newark, DE 19713-2072
Phone
(302) 623-3866
NPI assigned
Aug 30, 2006
Last updated
Jun 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X C1-0008058 DE Primary

Addresses

Primary practice location

4735 Ogletown Stanton Rd
Suite 1204
Newark, DE 19713-2072

Mailing address

PO Box 30170
Wilmington, DE 19805-7170
Phone (302) 623-7019

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
I20070221000563 DE Practitioner - Urology 4486756467 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0008058DEMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc Urology CurrentSince Aug 1, 2006 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services Inc CurrentSince Aug 1, 2006 Accepting new patients

Locations

4735 Ogletown Stanton Rd
Ste 1204
Newark, DE 19713
Phone (302) 623-4175

4735 Ogletown Stanton Rd
Ste 2224
Newark, DE 19713
Phone (302) 266-0355

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1922118462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30170",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198057170",
            "telephone_number": "302-623-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN STANTON RD",
            "address_2": "SUITE 1204",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132072",
            "telephone_number": "302-623-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "SIDNEY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "DE",
            "license": "C1-0008058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.