NPIMap

Individual provider Active NPI

Michael E. Scovner, MD

  • Internal Medicine Physician
  • Poultney, VT
National Provider Identifier
1376615534
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042-0007746 Issued in VT
Practice address
236 Main St
Poultney, VT 05764-1106
Phone
(802) 287-2269
NPI assigned
Nov 14, 2006
Last updated
Jul 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 042-0007746 VT Primary

Addresses

Primary practice location

236 Main St
Poultney, VT 05764-1106

Mailing address

236 Main St
Poultney, VT 05764-1106

Other identifiers 1

IdentifierTypeStateIssuer
0009244MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091123000246 VT Practitioner - Internal MedicinePractitioner - Pediatric Medicine 5496894909 Practice locations: Poultney, VT

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Ohio State University College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

236 Main St
Poultney, VT 05764-1106
Phone (802) 287-2269

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rutland Hospital, Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1376615534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 MAIN ST",
            "city": "POULTNEY",
            "state": "VT",
            "postal_code": "057641106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 MAIN ST",
            "city": "POULTNEY",
            "state": "VT",
            "postal_code": "057641106",
            "telephone_number": "802-287-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOVNER",
        "first_name": "MICHAEL",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "042-0007746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009244",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poultney, VT

Sources for this page

Verify at the official NPI Registry.