Individual provider Active NPI

Terry Wesley Scott, M.D.

  • Otolaryngology Physician
  • Diamond Bar, CA
National Provider Identifier
1124183868
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G54536 Issued in CA
Practice address
1111 Grand Ave
# E
Diamond Bar, CA 91765-4171
Phone
(909) 860-7712
Fax
(909) 861-1311
NPI assigned
Dec 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G54536 CA Primary

Addresses

Primary practice location

1111 Grand Ave
# E
Diamond Bar, CA 91765-4171

Mailing address

1111 Grand Ave
# E
Diamond Bar, CA 91765-4171
Phone (909) 860-7712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230221001628 CA Practitioner - Otolaryngology 7719359777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Howard University College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1111 Grand Ave
Suite E
Diamond Bar, CA 91765-2227
Phone (909) 860-7712

Hospital & facility affiliations

  • Casa Colina Hospital Hospital, Pomona, CA, CCN 050782
  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G54536CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diamond Bar Ear Nose & Throat Specialty Medical Group, Inc. Otolaryngology CurrentSince Oct 5, 2022 Accepting new patients

Locations

1111 Grand Ave
Ste E
Diamond Bar, CA 91765
Phone (909) 860-7712

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124183868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 GRAND AVE",
            "address_2": "# E",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654171",
            "telephone_number": "909-860-7712",
            "fax_number": "909-861-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 GRAND AVE",
            "address_2": "# E",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654171",
            "telephone_number": "909-860-7712",
            "fax_number": "909-861-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "TERRY",
        "middle_name": "WESLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G54536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Bar, CA

Sources for this page

Verify at the official NPI Registry.