Individual provider Active NPI

Imara-Safi Olu Scott, MD

  • Dermatology Physician
  • Tallahassee, FL
National Provider Identifier
1053801001
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME170552 Issued in FL
Practice address
1632 Riggins Rd
Tallahassee, FL 32308-5316
Phone
(850) 877-4134
Fax
(850) 942-4112
NPI assigned
May 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 318278 NY
Dermatology Physician 207N00000X ME170552 FL Primary

Addresses

Primary practice location

1632 Riggins Rd
Tallahassee, FL 32308-5316

Mailing address

PO Box 13834
Tallahassee, FL 32317-3834
Phone (850) 205-6232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221003001431 NY Practitioner - Dermatology 8729338371 Reassigns benefits to 1 organization
I20250102000766 FL Practitioner - Dermatology 8729338371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Tennessee, HSC, College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1707 Riggins Rd
Tallahassee, FL 32308-5317
Phone (850) 877-4134

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision29
Removal of skin lesions730
Removal or shaving of skin growth33
Skin biopsy280

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
318278NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of Tallahassee, PA Dermatology CurrentSince Dec 30, 2024 Accepting new patients
Mariwalla Dermatology, PLLC CurrentSince Aug 1, 2022 Accepting new patients
Dermatology Associates of Tallahassee PA Dermatology CurrentSince Dec 30, 2024 Accepting new patients

Locations

19611 State Road 20 W
Blountstown, FL 32424
Phone (850) 674-5645

110 NE 5th St
Carrabelle, FL 32322
Phone (850) 697-1118

803 W Main St
Perry, FL 32347
Phone (850) 584-7078

1707 Riggins Rd
Tallahassee, FL 32308
Phone (850) 205-6232

1632 Riggins Rd
Tallahassee, FL 32308
Phone (850) 877-8166

1253 Montauk Hwy
West Islip, NY 11795
Phone (631) 661-1400

Organizations & group practices 3

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 1

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": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1053801001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13834",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323173834",
            "telephone_number": "850-205-6232",
            "fax_number": "855-975-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 RIGGINS RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085316",
            "telephone_number": "850-877-4134",
            "fax_number": "850-942-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "IMARA-SAFI",
        "middle_name": "OLU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "318278",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME170552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.