Individual provider Active NPI

Scott David Mithoefer, PA-C

  • Surgical Physician Assistant
  • Portsmouth, NH
National Provider Identifier
1578053914
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
333 Borthwick Avenue
Suite 402
Portsmouth, NH 03801
Phone
(603) 559-4111
NPI assigned
May 10, 2018
Last updated
Oct 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X NU Primary

Addresses

Primary practice location

333 Borthwick Avenue
Suite 402
Portsmouth, NH 03801

Mailing address

333 Borthwick Avenue
Suite 402
Portsmouth, NH 03801
Phone (603) 559-4111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20181204003869 NH Practitioner - Physician Assistant 8628312477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appledore Medical Group IncGroup PAC ID 5698666154, 197 clinicians

Practice addresses (Care Compare)

330 Borthwick Ave
Suite 308
Portsmouth, NH 03801-7112
Phone (603) 431-5242

333 Borthwick Ave
Portsmouth, NH 03801-7128

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1373NHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Appledore Medical Group, Inc CurrentSince Oct 14, 2018 Accepting new patients

Locations

330 Borthwick Ave
Ste 201
Portsmouth, NH 03801
Phone (603) 431-5242

330 Borthwick Ave
Ste 308
Portsmouth, NH 03801
Phone (603) 431-5242

333 Bothwick Ave
Ste 402
Portsmouth, NH 03801
Phone (603) 433-5110

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: scott.mithoefer@hca6.eclinicaldirectplus.com

Organizations & group practices 1

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 2

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": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1578053914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BORTHWICK AVENUE",
            "address_2": "SUITE 402",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03801",
            "telephone_number": "603-559-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 BORTHWICK AVENUE",
            "address_2": "SUITE 402",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03801",
            "telephone_number": "603-559-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITHOEFER",
        "first_name": "SCOTT",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-10",
        "last_updated": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.