Individual provider Active NPI

Sean Fenton Scott, M.D.

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1306859822
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD425202 Issued in PA
Practice address
4400 Haverford Ave
Health Care Center #4
Philadelphia, PA 19104-1361
Phone
(215) 685-7600
Fax
(215) 386-4902
NPI assigned
Aug 14, 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
Pediatrics Physician 208000000X MD425202 PA Primary

Addresses

Primary practice location

4400 Haverford Ave
Health Care Center #4
Philadelphia, PA 19104-1361

Mailing address

500 S Broad St
Suite 360
Philadelphia, PA 19146-1613
Phone (215) 685-6769

Other identifiers 1

IdentifierTypeStateIssuer
1014073880001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20051011000859 PA Practitioner - Pediatric Medicine 6406871235 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia CurrentSince Jan 11, 2016 Accepting new patients
City of Philadelphia CurrentSince Jan 11, 2016 Accepting new patients
City of Philadelphia Past Accepting new patients

Locations

4400 Haverford Ave
Philadelphia, PA 19104
Phone (215) 685-7504

1101 Market St
Fl 10
Philadelphia, PA 19107

321 W Girard Ave
Philadelphia, PA 19123
Phone (215) 685-3803

500 S Broad St
Ste 360
Philadelphia, PA 19146

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

Interoperability endpoints

  • Direct secure messaging: sean.scott@pdphahs.eclinicaldirectplus.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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306859822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S BROAD ST",
            "address_2": "SUITE 360",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461613",
            "telephone_number": "215-685-6769",
            "fax_number": "215-685-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 HAVERFORD AVE",
            "address_2": "HEALTH CARE CENTER #4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191041361",
            "telephone_number": "215-685-7600",
            "fax_number": "215-386-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "SEAN",
        "middle_name": "FENTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD425202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014073880001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.