Individual provider Active NPI

Scott B Chelemer, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Reston, VA
National Provider Identifier
1063497329
Registry record updated Feb 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
25MA06391900 Issued in NJ
Practice address
1768 Business Center Dr Ste 100
Reston, VA 20190-5359
Phone
(800) 762-9244
Fax
(786) 672-6006
NPI assigned
Dec 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA06391900 NJ
Pulmonary Disease Physician 207RP1001X 25MA06391900 NJ
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 25MA06391900 NJ Primary

Addresses

Primary practice location

1768 Business Center Dr Ste 100
Reston, VA 20190-5359

Mailing address

1768 Business Center Dr Ste 100
Reston, VA 20190-5359
Phone (786) 785-1514

Other identifiers 3

IdentifierTypeStateIssuer
04911368MedicaidNY
7228805MedicaidNJ
102450866-0001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200309000065 NJ Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 9335134105 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access Telecare, PLLC Internal Medicine CurrentSince Jan 28, 2023 Accepting new patients
Intensivist Group of Pennsylvania, PC Internal Medicine Past Accepting new patients

Locations

70 Dubois St
Fl 2
Newburgh, NY 12550
Phone (845) 561-4400

Organizations & group practices 2

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": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614470400000",
    "number": "1063497329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1768 BUSINESS CENTER DR STE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905359",
            "telephone_number": "786-785-1514",
            "fax_number": "786-672-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1768 BUSINESS CENTER DR STE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905359",
            "telephone_number": "800-762-9244",
            "fax_number": "786-672-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHELEMER",
        "first_name": "SCOTT",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2021-02-28",
        "certification_date": "2021-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06391900",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA06391900",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MA06391900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04911368",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7228805",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102450866-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.