Individual provider Active NPI

Scott E Myers, MD

  • Gastroenterology Physician
  • Philadelphia, PA
National Provider Identifier
1407839145
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD029968E Issued in PA
Practice address
219 N Broad St
5TH FL
Philadelphia, PA 19107-1519
Phone
(215) 762-6220
Fax
(215) 762-5034
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD029968E PA Primary

Addresses

Primary practice location

219 N Broad St
5TH FL
Philadelphia, PA 19107-1519

Mailing address

1601 Cherry St
Suite 11511
Philadelphia, PA 19102-1321
Phone (215) 255-7822

Other identifiers 2

IdentifierTypeStateIssuer
001150568MedicaidPA
5106401MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070907000230 PA Practitioner - Gastroenterology 3274572540 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06161500NJMDEmergency Medicine Physician
MD029968EPAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Hill Clinic Company, LLC CurrentSince Apr 1, 2020 Accepting new patients
Chestnut Hill Clinic Company, LLC Gastroenterology CurrentSince Apr 1, 2020 Accepting new patients
Drexel University CurrentSince Jul 1, 2014 Accepting new patients
Drexel University Gastroenterology CurrentSince Jul 1, 2014 Accepting new patients
Drexel University Current Accepting new patients
Philadelphia Gastroenterology Group, P.C. Gastroenterology PastSince May 13, 2014 Accepting new patients

Locations

219 N Broad St
Fl 5
Philadelphia, PA 19107
Phone (215) 762-6070

1601 Cherry St
Ste 11511
Philadelphia, PA 19102

1427 Vine St
Fl 2
Philadelphia, PA 19102
Phone (215) 762-2530

10 Shurs Ln
Philadelphia, PA 19127
Phone (215) 482-0899

230 N Broad St
Fl 4
Philadelphia, PA 19102
Phone (215) 762-1738

219 N Broad St
Fl 9
Philadelphia, PA 19107
Phone (215) 762-2688

1427 Vine St
Fl 8
Philadelphia, PA 19102
Phone (215) 762-6660

525 Jamestown St
Ste 101
Philadelphia, PA 19128
Phone (215) 463-1483

8200 Flourtown Ave
Ste 2
Wyndmoor, PA 19038
Phone (215) 836-5100

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1407839145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST",
            "address_2": "SUITE 11511",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021321",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N BROAD ST",
            "address_2": "5TH FL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071519",
            "telephone_number": "215-762-6220",
            "fax_number": "215-762-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "SCOTT",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD029968E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001150568",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5106401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.