Organization Active NPI

Delmarva Radiation Services, PA

  • Radiation Oncology Physician
  • Rehoboth Beach, DE
National Provider Identifier
1992740906
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
DELMARVA RADIATION SERVICES, PA
Practice address
18947 John J Williams Hwy
Rehoboth Beach, DE 19971-4474
Phone
(302) 645-3775
Fax
(302) 645-3774
NPI assigned
Jun 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Authorized official

Name
Dr. Brian J Costleigh, MDNPI 1932101144
Title
Medical Director/President
Phone
(302) 645-3775

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
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

18947 John J Williams Hwy
Rehoboth Beach, DE 19971-4474

Mailing address

PO Box 497
Lewes, DE 19958-0497
Phone (302) 645-3775

Other identifiers 2

IdentifierTypeStateIssuer
1000038787MedicaidDE
DE4449OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050628000401 DE Part B Supplier - Clinic/Group Practice 6507801750 Receives reassigned benefits from 3 practitioners
Practice locations: Frankford, DE; Rehoboth Beach, DE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623369600000",
    "number": "1992740906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 497",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199580497",
            "telephone_number": "302-645-3775",
            "fax_number": "302-645-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18947 JOHN J WILLIAMS HWY",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199714474",
            "telephone_number": "302-645-3775",
            "fax_number": "302-645-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELMARVA RADIATION SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A",
        "authorized_official_last_name": "COSTLEIGH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/PRESIDENT",
        "authorized_official_telephone_number": "302-645-3775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000038787",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE4449",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rehoboth Beach, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.