Individual provider Active NPI

John Scalici, PT

  • Physical Therapist
  • Hampton, VA
National Provider Identifier
1376571190
Registry record updated May 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305204675 Issued in VA
Practice address
2106 Executive Dr
Hampton, VA 23666-2402
Phone
(757) 838-6678
Fax
(757) 838-8116
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0090391 NY
Physical Therapist 225100000X 2305204675 VA Primary

Addresses

Primary practice location

2106 Executive Dr
Hampton, VA 23666-2402

Mailing address

PO Box 69030
Baltimore, MD 21264-9030
Phone (757) 873-2306

Other identifiers 4

IdentifierTypeStateIssuer
192971OtherVABCBS PHY THERAPY
7500685OtherVAAETNA
010344352MedicaidVA
P00395282OtherVARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070402000658 VA Practitioner - Physical Therapist in Private Practice 3476517061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Physical Therapy LLCGroup PAC ID 6406759281, 225 clinicians

Practice addresses (Care Compare)

10128 W Broad St
Forum Building III Suite K
Glen Allen, VA 23060-6761
Phone (804) 217-9210

2106 Executive Dr
Hampton, VA 23666-2402
Phone (757) 838-6678

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
85.78
Promoting interoperability
99
Improvement activities
40
Cost
75.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0090391NYMDPhysical Therapist
2305204675VAMDPhysical Therapist
009039NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Sep 11, 2006 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Sep 11, 2006 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist Current Accepting new patients
Island Sports Physiotherapy, PC Past Accepting new patients
Island Sports Physical Therapy of Smithtown, P.C. Past Accepting new patients
Island Sports Physiotherapy, PC Past Accepting new patients

Locations

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

2106 Executive Dr
Hampton, VA 23666
Phone (757) 838-6678

771 Pilot House Dr
#A
Newport News, VA 23606
Phone (757) 873-2302

Organizations & group practices 6

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525305600000",
    "number": "1376571190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69030",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212649030",
            "telephone_number": "757-873-2306",
            "fax_number": "757-873-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 EXECUTIVE DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662402",
            "telephone_number": "757-838-6678",
            "fax_number": "757-838-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCALICI",
        "first_name": "JOHN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2018-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0090391",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PHY THERAPY",
            "identifier": "192971",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7500685",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010344352",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00395282",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.