NPIMap

Individual provider Active NPI

Nico D Roscoe, M.D.

  • Family Medicine Physician
  • Du Bois, PA
National Provider Identifier
1386869774
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD442234 Issued in PA
Practice address
33 Beaver Dr
Suite 1
Du Bois, PA 15801-2434
Phone
(814) 503-8070
Fax
(814) 503-8531
NPI assigned
Apr 13, 2007
Last updated
Mar 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD442234 PA Primary

Addresses

Primary practice location

33 Beaver Dr
Suite 1
Du Bois, PA 15801-2434

Mailing address

33 Beaver Dr
Suite 1
Du Bois, PA 15801-2434
Phone (814) 503-8070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20120911000434 PA Practitioner - Family Practice 6709929482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clearfield-Jefferson Primary Care Associates PCGroup PAC ID 6002064433, 73 clinicians

Practice addresses (Care Compare)

15 N Front St
Clearfield, PA 16830-2455
Phone (814) 503-8070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD442234PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clearfield-Jefferson Primary Care Associates PC Family Medicine CurrentSince Jul 18, 2012 Accepting new patients
Havencrest Rehabilitation and Healthcare Center LLC Past Accepting new patients
Eldercrest Rehabilitation & Healthcare Center LLC Past Accepting new patients
Addiction and Recovery Health Services PastSince Jan 1, 2020 Accepting new patients
Sycamore Creek Healthcare Group, Inc Past Accepting new patients
Kittanning Health & Rehab Center, LLC Past Accepting new patients
Westmoreland County Past Accepting new patients
SCS Opco LLC Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Washington Operating LLC Past Accepting new patients
Hilltop Heights Health & Rehab Center, LLC Past Accepting new patients
St. Anne Home Past Accepting new patients
Guardian Elder Care at Monongahela LLC Past Accepting new patients
Guardian Elder Care at Munhall LLC Past Accepting new patients
Rolling Meadows Operating LLC Past Accepting new patients
Beaver Healthcare Operating, LLC Past Accepting new patients

Locations

15 N Front St
Clearfield, PA 16830
Phone (570) 561-2990

33 Beaver Dr
Ste 1
Dubois, PA 15801
Phone (570) 561-2990

521 Greenfield Ave
Pittsburgh, PA 15207
Phone (412) 422-6500

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1386869774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 BEAVER DR",
            "address_2": "SUITE 1",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012434",
            "telephone_number": "814-503-8070",
            "fax_number": "814-503-8531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 BEAVER DR",
            "address_2": "SUITE 1",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012434",
            "telephone_number": "814-503-8070",
            "fax_number": "814-503-8531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSCOE",
        "first_name": "NICO",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD442234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.