Peter L Scudera, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

0101047453 Issued in VA

Practice address

3700 Joseph Siewick Dr
Suite 308
Fairfax, VA 22033-1744

Phone

(703) 698-8960

Fax

(647) 646-4744

NPI assigned

Feb 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in DC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Gastroenterology Associates of Northern Virginia, LLC

  • Gastroenterology Physician
  • Fairfax, VA
  • NPI 1205884368

  DC

  Medicare reassignment NPD
• Old Dominion Anesthesia LLC

  • Anesthesiology Physician
  • Charlottesville, VA
  • NPI 1902248677
  NPD (past)

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1063488575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR",
            "address_2": "SUITE 308",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331744",
            "telephone_number": "703-698-8960",
            "fax_number": "703-716-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR",
            "address_2": "SUITE 308",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331744",
            "telephone_number": "703-698-8960",
            "fax_number": "647-646-4744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3028 Javier Rd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220314622",
            "country_code": "US",
            "telephone_number": "703-698-8960",
            "fax_number": "571-494-5794",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3914 Centreville Rd Ste 350",
            "address_purpose": "LOCATION",
            "city": "Chantilly",
            "state": "VA",
            "postal_code": "201513289",
            "country_code": "US",
            "telephone_number": "703-716-8700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCUDERA",
        "first_name": "PETER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101047453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "334231",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "334232",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "178708",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "187600",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "452928",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6031102",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "341905",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100013570",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "79160011",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rieta Scott, NP
• Tresa Anne Scott, LCSW-C
• Daniel Howard Scrafford
• Matthew H Scriven, MD
• Jennifer Scrivener, PMHNP
• Stephenie Ashley Scully, M.D.
• Saundra L Seaman, MD
• Michael Louis Searby, LPC, NCC
• Virginia Elise Seay, NP-BC
• James A Sebben, LPC, LMFT

• Gastroenterology Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Gastroenterology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.