Shelby Nicole Scullen, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

352028 Issued in NY

Practice address

22567 Summit Dr BLDG II
Watertown, NY 13601-7210

Phone

(315) 782-7230

NPI assigned

Aug 16, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shelby Nicole Sheehan Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Samaritan Medical CenterGroup PAC ID 8123914876, 157 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Samaritan Medical Center Hospital, Watertown, NY, CCN 330157
• Lewis County General Hospital Hospital, Lowville, NY, CCN 331317
• Canton-Potsdam Hospital Hospital, Potsdam, NY, CCN 330197
• Gouverneur Hospital Hospital, Gouverneur, NY, CCN 331315
• River Hospital Clinics Hospital, Alexandria Bay, NY, CCN 331309

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shelby.scullen@sfhcny.eclinicaldirectplus.com

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.

• Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
  • NPI 1598713745
  Medicare reassignment Care Compare group NPD
• Samaritan Medical Center

  • Rehabilitation Hospital Unit
  • Watertown, NY
  • NPI 1093722068
  NPD

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

• Canton-Potsdam Hospital

  • General Acute Care Hospital
  • Potsdam, NY
  • NPI 1568548782
  Care Compare affiliation
• Gouverneur Hospital

  • Critical Access Hospital
  • Gouverneur, NY
  • NPI 1629409925
  Care Compare affiliation
• Lewis County

  • Rural Acute Care Hospital
  • Lowville, NY
  • NPI 1487689402
  Care Compare affiliation
• Lewis County General Hospital

  • Critical Access Hospital
  • Lowville, NY
  • NPI 1619390838
  Care Compare affiliation
• River Hospital, Inc.

  • Critical Access Hospital
  • Alexandria Bay, NY
  • NPI 1003814641
  Care Compare affiliation
• River Hospital, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Alexandria Bay, NY
  • NPI 1821022781
  Care Compare affiliation
• Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
  • NPI 1598713745
  Care Compare affiliation

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1194508952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 HINMAN RD",
            "city": "PULASKI",
            "state": "NY",
            "postal_code": "131422321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22567 SUMMIT DR BLDG II",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136017210",
            "telephone_number": "315-782-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLEN",
        "first_name": "SHELBY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "352028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "SHEEHAN",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dawn Lillian Scott, ANP-BC
• Jadah Scott
• Mackenzie Scott, PT, DPT
• Terri J Scoville, O.T.
• Trevor James Harry Scudamore, M.D.
• Rory Allayn Sears, D.O.
• Shauna Fae Seitz, MS, OTR/L
• Tabatha M Sellick, SW
• Mariana Olga Serback, MS, RDN
• Bonnie L Servage, ANP

• Family Nurse Practitioner in Watertown, NY
• Providers in Watertown, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.