Individual provider Active NPI

Cassidy Scott

  • Family Medicine Physician
  • Bradenton, FL
National Provider Identifier
1164001376
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS21390 Issued in FL
Practice address
5123 4TH Avenue Cir E
Bradenton, FL 34208-5620
Phone
(941) 744-5510
NPI assigned
Apr 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS21390 FL Primary

Addresses

Primary practice location

5123 4TH Avenue Cir E
Bradenton, FL 34208-5620

Mailing address

5123 4TH Avenue Cir E
Bradenton, FL 34208-5620
Phone (941) 744-5510

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
I20241015004456 FL Practitioner - Family Practice 0547668550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooper Family Medical PLLCGroup PAC ID 9931171782, 19 clinicians

Practice addresses (Care Compare)

5123 4TH Ave Cir E
Bradenton, FL 34208-5620
Phone (941) 744-5510

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Family Medical PLLC Family Medicine CurrentSince Sep 1, 2024 Accepting new patients

Locations

5123 4th Avenue Cir E
Bradenton, FL 34208
Phone (941) 744-5510

Interoperability endpoints

  • Direct secure messaging: cassidy.scott.1@26999.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/26999/brand/2/csg/1/fhir/r4

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 5

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": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1164001376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5123 4TH AVENUE CIR E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085620",
            "telephone_number": "941-744-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5123 4TH AVENUE CIR E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085620",
            "telephone_number": "941-744-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "CASSIDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-08-29",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS21390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.