Individual provider Active NPI

Alysa Pat Scavone

  • Occupational Therapist
  • Edwardsville, PA
National Provider Identifier
1346824877
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC011908 Issued in PA
Practice address
115 Gateway Shopping Ctr
Edwardsville, PA 18704-4403
Phone
(570) 938-4634
NPI assigned
May 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC011908 PA Primary

Addresses

Primary practice location

115 Gateway Shopping Ctr
Edwardsville, PA 18704-4403

Mailing address

178 Center St
Covington Township, PA 18424-7813
Phone (570) 706-5550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210810000480 PA Practitioner - Occupational Therapist in Private Practice 9830593169 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OC011908PAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hodi Lymphatic Center LLC Occupational Therapist CurrentSince May 10, 2021 Accepting new patients

Locations

115 Gateway Shopping Ctr
Kingston, PA 18704
Phone (570) 938-4634

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.

NPI Registry JSON

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1346824877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 CENTER ST",
            "city": "COVINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184247813",
            "telephone_number": "570-706-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 GATEWAY SHOPPING CTR",
            "city": "EDWARDSVILLE",
            "state": "PA",
            "postal_code": "187044403",
            "telephone_number": "570-938-4634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCAVONE",
        "first_name": "ALYSA",
        "middle_name": "PAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC011908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.