Individual provider Active NPI

Scottie Galik Paitl, MD

  • Neonatal-Perinatal Medicine Physician
  • Voorhees, NJ
National Provider Identifier
1114308020
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
036.146598 Issued in IL
Practice address
1000 Haddonfield Berlin Rd Ste 210
Voorhees, NJ 08043-3520
Phone
(856) 782-2212
Fax
(856) 782-2212
NPI assigned
Jun 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 036.146598 IL Primary

Addresses

Primary practice location

1000 Haddonfield Berlin Rd Ste 210
Voorhees, NJ 08043-3520

Mailing address

1000 Haddonfield Berlin Rd Ste 210
Voorhees, NJ 08043-3520
Phone (856) 782-2212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20220929000383 IA Practitioner - Pediatric Medicine 3870808033 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.146598ILMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Sep 21, 2022 Accepting new patients
Genesis Health System Pediatrics CurrentSince Sep 21, 2022 Accepting new patients
Onsite Neonatal Iowa PC Neonatal-Perinatal Medicine Past Accepting new patients
Ascension Borgess Hospital Past Accepting new patients

Locations

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160

619 5th St
Durant, IA 52747
Phone (563) 785-4487

Organizations & group practices 5

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": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1114308020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HADDONFIELD BERLIN RD STE 210",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433520",
            "telephone_number": "856-782-2212",
            "fax_number": "856-782-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HADDONFIELD BERLIN RD STE 210",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433520",
            "telephone_number": "856-782-2212",
            "fax_number": "856-782-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAITL",
        "first_name": "SCOTTIE",
        "middle_name": "GALIK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2023-03-06",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IL",
            "license": "036.146598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.