Individual provider Active NPI

Paul Kendall Pulchny, D.O.

  • Family Medicine Physician
  • Milton, DE
National Provider Identifier
1992098412
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C2-0010941 Issued in DE
Practice address
630 Mulberry St
Milton, DE 19968-1516
Phone
(302) 684-8053
Fax
(302) 684-8059
NPI assigned
May 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C2-0010941 DE Primary

Addresses

Primary practice location

630 Mulberry St
Milton, DE 19968-1516

Mailing address

640 S. State Street
Mail Code 3055
Dover, DE 19901-3530
Phone (302) 480-1688

Other identifiers 1

IdentifierTypeStateIssuer
200138225MedicaidDE

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
I20140812000134 DE Practitioner - Family Practice 5698928588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bayhealth Medical Center, IncGroup PAC ID 1658364740, 399 clinicians

Practice addresses (Care Compare)

630 Mulberry St
Milton, DE 19968-1516
Phone (302) 684-8053

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5266OKMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc Family Medicine CurrentSince Aug 1, 2014 Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Aug 1, 2014 Accepting new patients
Integris Rural Health Inc Family Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

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

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

630 Mulberry St
Milton, DE 19968
Phone (302) 684-8053

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1992098412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S. STATE STREET",
            "address_2": "MAIL CODE 3055",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-480-1688",
            "fax_number": "302-480-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 MULBERRY ST",
            "city": "MILTON",
            "state": "DE",
            "postal_code": "199681516",
            "telephone_number": "302-684-8053",
            "fax_number": "302-684-8059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULCHNY",
        "first_name": "PAUL",
        "middle_name": "KENDALL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-17",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C2-0010941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200138225",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, DE

Sources for this page

Verify at the official NPI Registry.