NPIMap

Individual provider Active NPI

Rebecca Scully

  • Vascular Surgery Physician
  • Boston, MA
National Provider Identifier
1104260900
Registry record updated Jun 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
2086S0129X Issued in NH
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 335-8204
NPI assigned
Apr 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 2086S0129X NH Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

PO Box 810
Hanover, NH 03755-0810
Phone (603) 650-8050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221101000235 NH Practitioner - Vascular Surgery 2769603687 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Geisel School of Medicine at Dartmouth, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

100 Hitchcock Way
Manchester, NH 03104-4125
Phone (603) 695-2500

2300 Southwood Dr
Nashua, NH 03063-1818
Phone (603) 577-4000

253 Pleasant St
Concord, NH 03301-7560
Phone (603) 226-2200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)16
Removal of tissue11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2086S0129XNHMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cheshire Medical Center CurrentSince Sep 6, 2022 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Sep 6, 2022 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Sep 6, 2022 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Sep 6, 2022 Accepting new patients
Cheshire Medical Center Current Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Sep 6, 2022 Accepting new patients

Locations

253 Pleasant St
Concord, NH 03301
Phone (603) 226-2200

590 Court St
Keene, NH 03431
Phone (603) 354-5454

580 Court St
Keene, NH 03431
Phone (603) 354-5454

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

100 Hitchcock Way
Manchester, NH 03104
Phone (603) 629-1870

2300 Southwood Dr
Nashua, NH 03063
Phone (603) 577-4170

Interoperability endpoints

  • Direct secure messaging: rscully490002@direct.dartmouth-hitchcock.org

Organizations & group practices 6

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1104260900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037550810",
            "telephone_number": "603-650-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-335-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLY",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-23",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NH",
            "license": "2086S0129X",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.