Individual provider Active NPI

Scott A. Schroeder, D.P.M.

  • Podiatrist
  • Wenatchee, WA
National Provider Identifier
1124054911
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO00000438 Issued in WA
Practice address
616 N Chelan Ave
Wenatchee, WA 98801-2025
Phone
(509) 662-2970
Fax
(509) 665-9808
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Podiatrist 213ER0200X PO00000438 WA
Foot Surgery Podiatrist 213ES0131X PO00000438 WA
Podiatrist 213E00000X PO00000438 WA Primary
Foot & Ankle Surgery Podiatrist 213ES0103X PO00000438 WA

Addresses

Primary practice location

616 N Chelan Ave
Wenatchee, WA 98801-2025

Mailing address

616 N Chelan Ave
Wenatchee, WA 98801-2025
Phone (509) 662-2970

Other identifiers 4

IdentifierTypeStateIssuer
CS9149OtherWAPALMETTO GBA RAILROAD MEDICARE PART B
0035677OtherWAWA STATE LABOR AND INDUSTRY
1057256MedicaidWA
480015509OtherWAPALMETTO GBA - RAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO00000438WAMDPodiatrist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1124054911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012025",
            "telephone_number": "509-662-2970",
            "fax_number": "509-665-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012025",
            "telephone_number": "509-662-2970",
            "fax_number": "509-665-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "SCOTT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "WA",
            "license": "PO00000438",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "WA",
            "license": "PO00000438",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO00000438",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO00000438",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MEDICARE PART B",
            "identifier": "CS9149",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE LABOR AND INDUSTRY",
            "identifier": "0035677",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1057256",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA -  RAILROAD MEDICARE",
            "identifier": "480015509",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.