NPIMap

Individual provider Active NPI

Luis Eduardo Scaccabarrozzi, MD, MPH

  • Pediatrics Physician
  • Gainesville, FL
National Provider Identifier
1629077318
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME90127 Issued in FL
Practice address
6440 W Newberry Rd
Suite 105
Gainesville, FL 32605-4381
Phone
(352) 332-4400
Fax
(352) 332-0086
NPI assigned
Jul 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2006001810 MO
Pediatrics Physician 208000000X ME90127 FL Primary

Addresses

Primary practice location

6440 W Newberry Rd
Suite 105
Gainesville, FL 32605-4381

Mailing address

6400 W Newberry Rd Ste 109
Gainesville, FL 32605-4388
Phone (352) 332-4400

Other identifiers 2

IdentifierTypeStateIssuer
269442500MedicaidFL
1629077318OtherFLNPI

Other names 1

  • Dr. Luis E Scaccabarrozzi Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME90127FLMDPediatrics Physician
2006001810MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Doc Pediatrics Pediatrics Past Accepting new patients
Privia Medical Group Florida, LLC Past Accepting new patients
Munchkins Pediatrics, LLC. Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19558/brand/1/csg/1/fhir/r4
  • Direct secure messaging: luis.scaccabarrozzi.1@19558.direct.athenahealth.com
  • Direct secure messaging: luis.scaccabarrozzi.1@8042.direct.athenahealth.com

Organizations & group practices 3

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": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1629077318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 W NEWBERRY RD STE 109",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054388",
            "telephone_number": "352-332-4400",
            "fax_number": "352-332-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 W NEWBERRY RD",
            "address_2": "SUITE 105",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054381",
            "telephone_number": "352-332-4400",
            "fax_number": "352-332-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCACCABARROZZI",
        "first_name": "LUIS",
        "middle_name": "EDUARDO",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2006001810",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME90127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269442500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1629077318",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUIS",
            "last_name": "SCACCABARROZZI",
            "middle_name": "E",
            "prefix": "DR.",
            "credential": "MD, MPH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.