Individual provider Active NPI

Scott Allen Nelson, PA

  • Medical Physician Assistant
  • Green Cove Springs, FL
National Provider Identifier
1376716621
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 2964 Issued in FL
Practice address
801 Oak St
Green Cove Springs, FL 32043-4317
Phone
(904) 276-2044
Fax
(904) 276-2106
NPI assigned
Apr 8, 2008
Last updated
Dec 15, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 2964 FL Primary

Addresses

Primary practice location

801 Oak St
Green Cove Springs, FL 32043-4317

Mailing address

1893 Kingsley Ave
Suite C
Orange Park, FL 32073-4491
Phone (904) 276-2044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20131205001039 FL Practitioner - Physician Assistant 9234366857 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eugene H McCoskey DO PAGroup PAC ID 2961781984, 4 clinicians

Practice addresses (Care Compare)

1555 Kingsley Ave
Suite 404
Orange Park, FL 32073-9207
Phone 9043883357201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 2964FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Specialists of Jacksonville Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: snelson78958@direct.acumenmd.com

Organizations & group practices 4

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 1

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": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1376716621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 KINGSLEY AVE",
            "address_2": "SUITE C",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734491",
            "telephone_number": "904-276-2044",
            "fax_number": "904-276-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OAK ST",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320434317",
            "telephone_number": "904-276-2044",
            "fax_number": "904-276-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SCOTT",
        "middle_name": "ALLEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-08",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 2964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Cove Springs, FL

Sources for this page

Verify at the official NPI Registry.