Individual provider Active NPI

Scott W McInnis, M.D.

  • Anesthesiology Physician
  • Whittier, CA
National Provider Identifier
1679544274
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G71029 Issued in CA
Practice address
15141 Whittier Blvd
Suite 130
Whittier, CA 90603-2135
Phone
(562) 945-2832
NPI assigned
Jan 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G71029 CA Primary

Addresses

Primary practice location

15141 Whittier Blvd
Suite 130
Whittier, CA 90603-2135

Mailing address

210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (800) 883-7243

Other identifiers 1

IdentifierTypeStateIssuer
00G710290MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20160211000674 IL Practitioner - Anesthesiology 1254379415 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G71029CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palos Hills Surgery Center LLC Anesthesiology CurrentSince Aug 11, 2018 Accepting new patients
Ambulatory Anesthesiologists of Chicago, LLC Anesthesiology CurrentSince Jan 2, 2016 Accepting new patients
Northstar Anesthesia of Illinois, LLC Anesthesiology CurrentSince Jul 1, 2024 Accepting new patients
Advocate Southwest Ambulatory Surgery Center LLC Past Accepting new patients

Locations

10330 S Roberts Rd
Palos Hills, IL 60465
Phone (708) 237-7200

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

27650 Ferry Rd
Warrenville, IL 60555
Phone (630) 225-2345

Organizations & group practices 4

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1679544274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "800-883-7243",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15141 WHITTIER BLVD",
            "address_2": "SUITE 130",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906032135",
            "telephone_number": "562-945-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNIS",
        "first_name": "SCOTT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G71029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G710290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.