Individual provider Active NPI

Elizabeth Scott, APRN

  • Family Nurse Practitioner
  • Half Moon Bay, CA
National Provider Identifier
1265787170
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
005077 Issued in CT
Practice address
225 Cabrillo Hwy South
Suite 100a
Half Moon Bay, CA 94019
Phone
(203) 237-2229
NPI assigned
Jul 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 99543 CT
Family Nurse Practitioner 363LF0000X 005077 CT Primary

Addresses

Primary practice location

225 Cabrillo Hwy South
Suite 100a
Half Moon Bay, CA 94019

Mailing address

225 Cabrillo Hwy South
Suite 100a
Half Moon Bay, CA 94019
Phone (860) 347-6971

Other identifiers 1

IdentifierTypeStateIssuer
004236346MedicaidCT

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200228001146 CA Practitioner - Nurse Practitioner 7315373487 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
99543CTMDRegistered Nurse
95095245CAMDDiabetes Educator Registered Nurse
005077CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Jan 1, 2020 Accepting new patients
County of San Mateo CurrentSince Jan 1, 2020 Accepting new patients
County of San Mateo CurrentSince Jan 1, 2020 Accepting new patients

Locations

225 Cabrillo Hwy S
Ste 100A
Half Moon Bay, CA 94019
Phone (650) 712-7330

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Interoperability endpoints

  • Direct secure messaging: escott21278@smch.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1265787170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CABRILLO HWY SOUTH",
            "address_2": "SUITE 100A",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "94019",
            "telephone_number": "860-347-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CABRILLO HWY SOUTH",
            "address_2": "SUITE 100A",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "94019",
            "telephone_number": "203-237-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "99543",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "005077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236346",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Half Moon Bay, CA

Sources for this page

Verify at the official NPI Registry.