Individual provider Active NPI

Chad Douglas Scheller, MD

  • Pediatric Critical Care Medicine Physician
  • Hollywood, FL
National Provider Identifier
1114044146
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
ME-129-467 Issued in FL
Practice address
3501 Johnson St Dept of
Hollywood, FL 33021
Phone
(954) 265-6301
Fax
(954) 985-1434
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X ME129467 FL
Pediatric Critical Care Medicine Physician 2080P0203X ME-129-467 FL Primary

Addresses

Primary practice location

3501 Johnson St Dept of
Hollywood, FL 33021

Mailing address

1117 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4488
Phone (954) 454-5131

Other identifiers 1

IdentifierTypeStateIssuer
019-030-100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cscheller153377@MHSDIRECT.NET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180711003575 FL Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 8325394968 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME129467FLMDPediatric Cardiology Physician
ME-129-467FLMDPediatric Critical Care Medicine Physician

Interoperability endpoints

  • Direct secure messaging: cscheller153377@mhsdirect.net

Organizations & group practices 1

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1114044146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 E HALLANDALE BEACH BLVD",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094488",
            "telephone_number": "954-454-5131",
            "fax_number": "954-241-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST DEPT OF",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-265-6301",
            "fax_number": "954-985-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHELLER",
        "first_name": "CHAD",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "ME129467",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME-129-467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019-030-100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cscheller153377@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "3501 Johnson St Dept Of",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.