Individual provider Active NPI

Scott Edward Teagarden, PT

  • Specialist
  • New York, NY
National Provider Identifier
1043307556
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
011165-1 Issued in NY
Practice address
220 West 26TH St
Wellness and Rehbilitation Center
New York, NY 10001
Phone
(212) 337-5814
Fax
(212) 924-5049
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 011165-1 NY Primary

Addresses

Primary practice location

220 West 26TH St
Wellness and Rehbilitation Center
New York, NY 10001

Mailing address

360 Cabrini Blvd
Apt. 5J
New York, NY 10040-3635
Phone (646) 662-3804

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051214000003 NY Practitioner - Physical Therapist in Private Practice 6709807134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
May accept Medicare assignment
Group practices
Thrive Integrated Physical Therapy PCGroup PAC ID 9739152935, 10 clinicians

Practice addresses (Care Compare)

594 Broadway
New York, NY 10012-3257
Phone (212) 254-7750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011165-1NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Integrated Physical Therapy, PC CurrentSince Jul 1, 2024 Accepting new patients

Locations

594 Broadway
Ste 702
New York, NY 10012
Phone (212) 254-7750

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043307556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 CABRINI BLVD",
            "address_2": "APT. 5J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100403635",
            "telephone_number": "646-662-3804",
            "fax_number": "212-924-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 WEST 26TH ST",
            "address_2": "WELLNESS AND REHBILITATION CENTER",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10001",
            "telephone_number": "212-337-5814",
            "fax_number": "212-924-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAGARDEN",
        "first_name": "SCOTT",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "011165-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.