Individual provider Active NPI

Daniel Joseph Scoppetta, MD

  • Surgery Physician
  • Bristol, CT
National Provider Identifier
1578587705
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
020591 Issued in CT
Practice address
25 Newell Rd
Suite D28
Bristol, CT 06010-5100
Phone
(860) 582-1220
Fax
(860) 582-6255
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 020591 CT Primary

Addresses

Primary practice location

25 Newell Rd
Suite D28
Bristol, CT 06010-5100

Mailing address

PO Box 2828
Bristol, CT 06011-2828
Phone (860) 585-3906

Other identifiers 1

IdentifierTypeStateIssuer
001205913MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20031217000592 CT Practitioner - General Surgery 7618872888 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020591CTMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Hospital Multi Specialty Group, Inc Surgery CurrentSince Jul 6, 2011 Accepting new patients
Surgical Associates of Bristol PC Surgery Past Accepting new patients

Locations

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

25 Newell Rd
Ste D28
Bristol, CT 06010
Phone (860) 582-1220

85 Beleden Gardens Dr
Bristol, CT 06010
Phone (860) 582-1220

Interoperability endpoints

  • Direct secure messaging: daniel.scoppetta@bhmg.eclinicaldirectplus.com

Organizations & group practices 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1578587705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2828",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060112828",
            "telephone_number": "860-585-3906",
            "fax_number": "860-585-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 NEWELL RD",
            "address_2": "SUITE D28",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105100",
            "telephone_number": "860-582-1220",
            "fax_number": "860-582-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOPPETTA",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "020591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001205913",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.