Active NPI
David Joseph Scopelliti, DMD
- Dentist
- Sayre, PA
National Provider Identifier
1487628152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS025428L
- Practice address
- 1 Guthrie SQ
Sayre, PA 18840-1625 - Phone
- (570) 888-5858
- NPI assigned
- Feb 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 048636-1 | NY | |
| Dentist | 122300000X | DS025428L | PA | Primary |
Addresses
Primary practice location
1 Guthrie SQ
Sayre, PA 18840-1625
Mailing address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GU039851 | Other | PA | PA MEDICARE GROUP |
| 190009642 | Other | PA | RR MEDICARE PIN |
| 0010875440001 | Medicaid | PA | |
| 01032342 | Medicaid | NY | |
| CC9269 | Other | PA | RR MEDICARE GROUP |
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110105000997 | PA | Practitioner - Oral Surgery | 1052317385 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048636-1 | NY | MD | Dentist |
| DS025428L | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guthrie Medical Group PC | Current | Accepting new patients | |
| Guthrie Medical Group, P.C. | Current | Accepting new patients | |
| Guthrie Medical Group, P.C. | Current | Accepting new patients | |
| Robert Packer Hospital | Current | Accepting new patients | |
| Guthrie Medical Group, P.C. | Current | Accepting new patients | |
| Guthrie Medical Group, P.C. | Past | Accepting new patients |
Locations
1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106
Interoperability endpoints
- dscopelliti7595@direct-guthrie.org
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.
-
- General Practice Physician
- Sayre, PA
- NPI 1245246644
-
- Family Medicine Physician
- Sayre, PA
- NPI 1508818733
-
- General Acute Care Hospital
- Sayre, PA
- NPI 1083614382
-
- Family Medicine Physician
- Troy, PA
- NPI 1376592493
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1487628152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 GUTHRIE SQ",
"city": "SAYRE",
"state": "PA",
"postal_code": "188401625",
"telephone_number": "570-888-5858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 GUTHRIE SQ",
"city": "SAYRE",
"state": "PA",
"postal_code": "188401625",
"telephone_number": "570-888-5858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOPELLITI",
"first_name": "DAVID",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-17",
"last_updated": "2021-03-08",
"certification_date": "2021-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "048636-1",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS025428L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA MEDICARE GROUP",
"identifier": "GU039851",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PIN",
"identifier": "190009642",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0010875440001",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01032342",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP",
"identifier": "CC9269",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sayre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.