Individual provider Active NPI

Albert Richard Scafuri Jr., M.D.

  • Family Medicine Physician
  • Bonita Springs, FL
National Provider Identifier
1245210350
Registry record updated Oct 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME60660 Issued in FL
Practice address
9776 Bonita Beach Rd
Suite 202B
Bonita Springs, FL 34135-4773
Phone
(239) 992-1500
Fax
(239) 992-3425
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2014

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 ME60660 FL Primary

Addresses

Primary practice location

9776 Bonita Beach Rd
Suite 202B
Bonita Springs, FL 34135-4773

Mailing address

9776 Bonita Beach Rd SE
#202B
Bonita Springs, FL 34135-4773
Phone (239) 992-1500

Other identifiers 3

IdentifierTypeStateIssuer
054705100MedicaidFL
0005867064OtherFLAETNA
17780OtherFLBCBSFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040727000969 FL Practitioner - Family Practice 3779553847 Practice locations: Bonita Springs, FL

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412553600000",
    "number": "1245210350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9776 BONITA BEACH RD SE",
            "address_2": "#202B",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354773",
            "telephone_number": "239-992-1500",
            "fax_number": "239-992-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9776 BONITA BEACH RD",
            "address_2": "SUITE 202B",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354773",
            "telephone_number": "239-992-1500",
            "fax_number": "239-992-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCAFURI",
        "first_name": "ALBERT",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2014-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME60660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054705100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005867064",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "17780",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.