Individual provider Active NPI

Paul J Scibetta Jr., DO

  • Orthopaedic Surgery Physician
  • Manchester, NH
National Provider Identifier
1093733164
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
9435 Issued in NH
Practice address
185 Queen City Ave
Manchester, NH 03101-7121
Phone
(603) 625-1655
Fax
(603) 626-4686
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2232 WV
Orthopaedic Surgery Physician 207X00000X 9435 NH Primary

Addresses

Primary practice location

185 Queen City Ave
Manchester, NH 03101-7121

Mailing address

185 Queen City Ave
Manchester, NH 03101-7121
Phone (603) 625-1655

Other identifiers 1

IdentifierTypeStateIssuer
3078110MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20040430000358 NH Practitioner - Orthopedic Surgery 6204823115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Rutgers New Jersey Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 622-6484

185 Queen City Ave
Manchester, NH 03101-7121
Phone (603) 314-6900

One Elliot Way
100 Elliot Cardiovascular Consultants
Manchester, NH 03103-3502
Phone (603) 627-1669

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9435NHMDOrthopaedic Surgery Physician
2232WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Professional Services CurrentSince Oct 31, 2010 Accepting new patients
Raleigh Orthopedic Center PLLC Orthopaedic Surgery PastSince Jul 1, 2007 Accepting new patients

Locations

185 Queen City Ave
Manchester, NH 03101
Phone (603) 314-6900

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

185 Queen City Ave
Unit 1
Manchester, NH 03101

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.

Hospital & facility affiliations 2

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1093733164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 QUEEN CITY AVE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031017121",
            "telephone_number": "603-625-1655",
            "fax_number": "603-626-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 QUEEN CITY AVE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031017121",
            "telephone_number": "603-625-1655",
            "fax_number": "603-626-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIBETTA",
        "first_name": "PAUL",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WV",
            "license": "2232",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NH",
            "license": "9435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3078110",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.