Scott Matthew Edmondson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00352600 Issued in NJ

Practice address

1 Cooper PLZ
Camden, NJ 08103-1461

Phone

(856) 342-2627

NPI assigned

Nov 17, 2007

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

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: sedmondson126458@direct.cooperhealth.edu

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.

• Cooper Univeristy Emergency Physicians, PC

  • Emergency Medicine Physician
  • Camden, NJ
  • NPI 1689694473
  Medicare reassignment
• Cooper Urgent Care, PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Cherry Hill, NJ
  • NPI 1205197365
  Medicare reassignment
• Cooper University Radiology, PC

  • Diagnostic Radiology Physician
  • Camden, NJ
  • NPI 1336188291
  NPD (past)

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

{
    "created_epoch": "1195257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707523200000",
    "number": "1104007285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935",
            "fax_number": "732-790-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Route 70 E",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080031200",
            "country_code": "US",
            "telephone_number": "856-396-6257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "SCOTT",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-17",
        "last_updated": "2024-02-10",
        "certification_date": "2024-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00352600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Dinnah Eclavia-Dy, CRNA
• Kay Allen Eddington, M.D.
• Deba Ede-Imafidon, DO
• Jonathan Edelstein
• Timma Alero Edem, MD
• Tina B. Edmonston, M.D.
• William Anthony Edwards Jr., DNP, APN, CRNA
• Caroline Eggerding, M.D.
• Tanya Egodage, M.D.
• Ernest Seth Egu, MD

• Physician Assistant in Camden, NJ
• Providers in Camden, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2024; 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.