NPIMap

Individual provider Active NPI

Deborah A Sculco, MD

  • Hematology & Oncology Physician
  • Amsterdam, NY
National Provider Identifier
1013910660
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
60470 Issued in GA
Practice address
4950 State Highway 30
Cancer Medicine Center
Amsterdam, NY 12010-7520
Phone
(518) 770-7557
Fax
(518) 770-7558
NPI assigned
May 27, 2005
Last updated
Jan 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 259006 NY
Hematology & Oncology Physician 207RH0003X 60470 GA Primary

Addresses

Primary practice location

4950 State Highway 30
Cancer Medicine Center
Amsterdam, NY 12010-7520

Mailing address

4950 State Highway 30
Cancer Medicine Center
Amsterdam, NY 12010-7520
Phone (518) 770-7557

Other identifiers 2

IdentifierTypeStateIssuer
001319054MedicaidCT
03380458MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120503000481 NY Practitioner - Hematology/Oncology 2567540297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Mary's HealthcareGroup PAC ID 7618960709, 114 clinicians

Practice addresses (Care Compare)

4950 State Hwy 30
Amsterdam, NY 12010-7520
Phone (518) 541-3600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
259006NYMDLicensed Practical Nurse
60470GAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Marys Healthcare CurrentSince Apr 1, 2012 Accepting new patients
St. Mary's Healthcare CurrentSince Apr 1, 2012 Accepting new patients
St. Mary's Healthcare Past Accepting new patients
Georgia Cancer Specialists I, PC Past Accepting new patients

Locations

380 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 841-7415

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

4950 State Highway 30
Amsterdam, NY 12010
Phone (518) 770-7557

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1013910660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 STATE HIGHWAY 30",
            "address_2": "CANCER MEDICINE CENTER",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120107520",
            "telephone_number": "518-770-7557",
            "fax_number": "518-770-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 STATE HIGHWAY 30",
            "address_2": "CANCER MEDICINE CENTER",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120107520",
            "telephone_number": "518-770-7557",
            "fax_number": "518-770-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULCO",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-27",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "259006",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "60470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001319054",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03380458",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amsterdam, NY

Sources for this page

Verify at the official NPI Registry.