Individual provider Active NPI

Dimitrios Moustakas, DPM

  • Podiatrist
  • Smyrna, DE
National Provider Identifier
1982131173
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E1-0000263 Issued in DE
Practice address
315 N Carter Rd
Smyrna, DE 19977-1282
Phone
(302) 730-4366
Fax
(302) 730-0231
NPI assigned
May 18, 2017
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E1-0000263 DE Primary

Addresses

Primary practice location

315 N Carter Rd
Smyrna, DE 19977-1282

Mailing address

640 S. State St
Mail Code 3055
Dover, DE 19901-3530
Phone (302) 730-4366

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200721000861 DE Practitioner - Podiatry 8426472770 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayhealth Medical Center, IncGroup PAC ID 1658364740, shared by 16 NPIs, 399 clinicians

Practice addresses (Care Compare)

315 N Carter Rd
Bayhealth Cardiology Consult Smyrna
Smyrna, DE 19977-1282
Phone (302) 672-4600

640 S State St
Dover, DE 19901-3530
Phone (302) 744-4700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue417
Removal of skin lesions25
Removal of nail tissue358
Removal or shaving of skin growth112
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc. CurrentSince Apr 15, 2024 Accepting new patients
Bayhealth Medical Center, Inc Current Accepting new patients
Bayhealth Medical Center, Inc. CurrentSince Apr 15, 2024 Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Apr 15, 2024 Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Apr 15, 2024 Accepting new patients
Bayhealth Medical Center, Inc Past Accepting new patients
Bayhealth Medical Center, Inc Past Accepting new patients

Locations

640 S State St
Dover, DE 19901
Phone (302) 744-4700

640 S State St
#3055
Dover, DE 19901
Phone (302) 480-1688

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

101 Wellness Way
Ste 250
Milford, DE 19963
Phone (302) 744-6220

315 N Carter Rd
Smyrna, DE 19977
Phone (302) 355-2383

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1982131173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S. STATE ST",
            "address_2": "MAIL CODE 3055",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-730-4366",
            "fax_number": "302-730-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N CARTER RD",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "199771282",
            "telephone_number": "302-730-4366",
            "fax_number": "302-730-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSTAKAS",
        "first_name": "DIMITRIOS",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-18",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "DE",
            "license": "E1-0000263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, DE

Sources for this page

Verify at the official NPI Registry.