Serita Scullark

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

312094 Issued in NY

Practice address

480 Bedford Rd
Chappaqua, NY 10514-1715

Phone

(914) 223-1700

NPI assigned

Mar 7, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Attentive Care General Practice of Medicine of NJ, PCGroup PAC ID 7416466636, 8 clinicians

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phelps Hospital Hospital, Sleepy Hollow, NY, CCN 330261
• Northern Westchester Hospital Hospital, Mount Kisco, NY, CCN 330162

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: sscullark60213@northwell.direct-ci.com
• Direct secure messaging: seritascullark@nslijmedgr.allscriptsdirect.net

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.

• Attentive Care General Practice of Medicine of NJ PC

  • Physical Medicine & Rehabilitation Physician
  • Cedarhurst, NY
  • NPI 1528877628

  NJ

  Medicare reassignment Care Compare group NPD
• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment Care Compare group NPD
• North Shore - Lij Medical PC

  dba NSLIJ Medical In Queens

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

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

• Northern Westchester Hospital Association

  dba Northern Westchester Hospital Transitional Care Unit

  • Medicare Defined Swing Bed Hospital Unit
  • Mount Kisco, NY
  • NPI 1396178356
  Care Compare affiliation
• Northern Westchester Hospital Association

  dba Northern Westchester Hospital

  • General Acute Care Hospital
  • Mount Kisco, NY
  • NPI 1912992215
  Care Compare affiliation
• Phelps Memorial Hospital Association

  dba Phelps Hospital

  • General Acute Care Hospital
  • Sleepy Hollow, NY
  • NPI 1720185267
  Care Compare affiliation

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

{
    "created_epoch": "1741305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1437958089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 BEDFORD RD",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "105141715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 BEDFORD RD",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "105141715",
            "telephone_number": "914-223-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLARK",
        "first_name": "SERITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "312094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Rusch, PT, DPT, GCS
• Alicia K Sands, LCSW
• Robert J Sanfilippo, D.C.
• Melissa Ann Schmitt, R.PH.
• Stefanie Robin Schwartz, MS, RD, CDN
• Elliott Seligman, PH.D.
• Selvaraj&Sullivan LLP
• Keisha Nicole Senior, LCSW
• Jhanvi Shah, PHARM. D
• Shari Rosen

• Nurse Practitioner in Chappaqua, NY
• Providers in Chappaqua, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.