NPIMap

Organization Active NPI

Bayhealth Medical Center, Inc

Doing business as Bayhealth Family Medicine Dover

  • Clinic/Center
  • Dover, DE
National Provider Identifier
1952996563
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BAYHEALTH MEDICAL CENTER, INC
Doing business as
Bayhealth Family Medicine Dover
Practice address
1074 S State St
Dover, DE 19901-6925
Phone
(302) 674-3970
NPI assigned
Mar 5, 2021
Last updated
Mar 5, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
BAYHEALTH MEDICAL CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Authorized official

Name
Michael Tretina, CPA, FHFMA, FACHE
Title
Senior VP/ Cfo
Phone
(302) 744-7162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1074 S State St
Dover, DE 19901-6925

Mailing address

640 S State St
Dover, DE 19901-3530
Phone (302) 744-6941

Other names 1

  • Bayhealth Family Medicine Dover Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001600 DE Part B Supplier - Clinic/Group Practice 1658364740 Receives reassigned benefits from 228 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dover, DE; Milford, DE

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
08D2215908Bayhealth Family Medicine, Dover1074 South State Street, Dover, DE 19901Provider-performed microscopyMar 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Bayheath Medical Center28 organizations share this tax ID, including this one
Part of
Bayheath Medical Center

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

826 S Governors Ave
Dover, DE 19904
Phone (302) 674-3752

804 N DuPont Blvd
Milford, DE 19963
Phone (302) 725-3557

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1952996563",
    "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",
            "telephone_number": "302-744-6941",
            "fax_number": "302-744-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1074 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199016925",
            "telephone_number": "302-674-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYHEALTH MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAYHEALTH MEDICAL CENTER, INC",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-02-15",
        "status": "A",
        "authorized_official_last_name": "TRETINA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "SENIOR VP/ CFO",
        "authorized_official_telephone_number": "302-744-7162",
        "authorized_official_credential": "CPA, FHFMA, FACHE"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayhealth Family Medicine Dover",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.