Organization Active NPI

Family Care of Easton, LLC

  • Family Medicine Physician
  • Easton, MD
National Provider Identifier
1982618617
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY CARE OF EASTON, LLC
Practice address
8579 Commerce Drive
Suite 106
Easton, MD 21601-7420
Phone
(410) 819-0404
Fax
(410) 819-0751
NPI assigned
Jul 28, 2006
Last updated
Dec 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Authorized official

Name
Susan E Delean-Botkin, CRNPNPI 1043306335
Title
Partner
Phone
(410) 819-0404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

8579 Commerce Drive
Suite 106
Easton, MD 21601-7420

Mailing address

8579 Commerce Drive
Suite 106
Easton, MD 21601-7420
Phone (410) 819-0404

Other identifiers 2

IdentifierTypeStateIssuer
404025200MedicaidMD
DB0501OtherMDRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060327000452 MD Part B Supplier - Clinic/Group Practice 3476561853 Receives reassigned benefits from 2 practitioners
Practice locations: Easton, MD

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
21D2318438Family Care of Easton8579 Commerce Dr #106, Easton, MD 21601Certificate of waiverFeb 10, 2027

National Provider Directory

National Provider Directory

Locations

8579 Commerce Dr
Ste 106
Easton, MD 21601
Phone (410) 819-0404

Practitioners & affiliated clinicians

Practitioners 3

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": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1982618617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8579 COMMERCE DRIVE",
            "address_2": "SUITE 106",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216017420",
            "telephone_number": "410-819-0404",
            "fax_number": "410-819-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8579 COMMERCE DRIVE",
            "address_2": "SUITE 106",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216017420",
            "telephone_number": "410-819-0404",
            "fax_number": "410-819-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE OF EASTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "DELEAN-BOTKIN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "410-819-0404",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404025200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB0501",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.