Individual provider Active NPI

Scott Robert Ottolini, M.D.

  • Emergency Medicine Physician
  • Fredericksburg, VA
National Provider Identifier
1598939704
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301087975 Issued in MI
Practice address
11404 Macpherson CT
Fredericksburg, VA 22407-2062
Phone
(313) 993-2530
Fax
(313) 993-7703
NPI assigned
Apr 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301087975 MI Primary

Addresses

Primary practice location

11404 Macpherson CT
Fredericksburg, VA 22407-2062

Mailing address

11404 Macpherson CT
Fredericksburg, VA 22407-2062
Phone (313) 993-2530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090714000198 VA Practitioner - Emergency Medicine 7012069677 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wayne State University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fredericksburg Emergency Medical Alliance, Inc.Group PAC ID 2163412636, 47 clinicians

Practice addresses (Care Compare)

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-1167

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301087975MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fredericksburg Emergency Medical Alliance, Inc. Emergency Medicine CurrentSince Jul 1, 2009 Accepting new patients
Mary Washington Healthcare Physicians CurrentSince Nov 18, 2018 Accepting new patients
Pathology Associates of Fredericksburg PTR Current Accepting new patients
Mary Washington Healthcare Physicians CurrentSince Nov 18, 2018 Accepting new patients
Bridging the Gaps Past Accepting new patients

Locations

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1598939704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11404 MACPHERSON CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224072062",
            "telephone_number": "313-993-2530",
            "fax_number": "313-993-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11404 MACPHERSON CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224072062",
            "telephone_number": "313-993-2530",
            "fax_number": "313-993-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTOLINI",
        "first_name": "SCOTT",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-17",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301087975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.