Scott D. Petersen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.002138 Issued in OH

Practice address

33300 Cleveland Clinic Blvd
Mail Code Avh4-143
Avon, OH 44011

Phone

(440) 695-5449

NPI assigned

Feb 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Physician Assistant

Education

George Washington University School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleveland Clinic Avon HospitalGroup PAC ID 0547552630, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Avon Hospital Hospital, Avon, OH, CCN 360364

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Cleveland Clinic Avon Hospital

  • General Acute Care Hospital
  • Avon, OH
  • NPI 1346607017

  OH

  Medicare reassignment Care Compare group
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919

  OH

  Medicare reassignment NPD
• The Cleveland Clinic Foundation

  • Family Medicine Physician
  • Avon, OH
  • NPI 1184428336
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cleveland Clinic Avon Hospital

  • General Acute Care Hospital
  • Avon, OH
  • NPI 1346607017

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1689640948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33300 CLEVELAND CLINIC BLVD",
            "address_2": "MAIL CODE AVH4-143",
            "city": "AVON",
            "state": "OH",
            "postal_code": "44011",
            "telephone_number": "440-695-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33300 CLEVELAND CLINIC BLVD",
            "address_2": "MAIL CODE AVH4-143",
            "city": "AVON",
            "state": "OH",
            "postal_code": "44011",
            "telephone_number": "440-695-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "SCOTT",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.002138",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "85000637",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02841",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Pavicic, M.ED, LPC
• David Manuel Perez, COTA/L
• Robert S Perhala, MD
• Jennifer Helen Peterman, COTA/L
• Lauren Peters, PA-C
• Sarah Petrella, M.A., CCC-SLP
• Diana Corina Petricele
• Philip Skovira OD Inc
• Una Phillips
• Tana Pierro

• Physician Assistant in Avon, OH
• Providers in Avon, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.