Individual provider Active NPI

Scott H Adkisson, D.O.

  • Anesthesiology Physician
  • Maywood, IL
National Provider Identifier
1063672921
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
125-052932 Issued in IL
Practice address
2160 S 1St Ave
Dept of Anesthesiology
Maywood, IL 60153-3328
Phone
(708) 216-9169
NPI assigned
Jun 13, 2008
Last updated
Jun 13, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 125-052932 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Dept of Anesthesiology
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
Dept of Anesthesiology
Maywood, IL 60153-3328
Phone (708) 216-9169

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20120130000455 OH Practitioner - Anesthesiology 8729245089 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Kansas City College of Medicine and Surgery, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Group Practice IncGroup PAC ID 1254245137, 396 clinicians

Practice addresses (Care Compare)

10500 Montgomery Rd
Montgomery, OH 45242-4402
Phone (513) 865-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-052932ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Group Practice, Inc Anesthesiology CurrentSince Mar 1, 2022 Accepting new patients
Sandusky Anesthesia LLC CurrentSince Feb 16, 2022 Accepting new patients

Locations

600 N Pickaway St
Circleville, OH 43113
Phone (614) 352-6479

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

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

Hospital & facility affiliations 6

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": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1063672921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "DEPT OF ANESTHESIOLOGY",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "DEPT OF ANESTHESIOLOGY",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADKISSON",
        "first_name": "SCOTT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-13",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125-052932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.