Individual provider Active NPI

Josephine Scottodicarlo, M.D.

  • Pediatrics Physician
  • Springfield, MA
National Provider Identifier
1699739714
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
54977 Issued in MA
Practice address
305 Bicentennial Hwy
Springfield, MA 01118-1962
Phone
(413) 733-4101
Fax
(413) 796-6821
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 54977 MA Primary

Addresses

Primary practice location

305 Bicentennial Hwy
Springfield, MA 01118-1962

Mailing address

305 Bicentennial Hwy
Springfield, MA 01118-1962
Phone (413) 733-4101

Other identifiers 1

IdentifierTypeStateIssuer
3001857MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050329000305 MA Practitioner - Pediatric Medicine 0244286672 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54977MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc Past Accepting new patients

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304899200000",
    "number": "1699739714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 BICENTENNIAL HWY",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011181962",
            "telephone_number": "413-733-4101",
            "fax_number": "413-796-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 BICENTENNIAL HWY",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011181962",
            "telephone_number": "413-733-4101",
            "fax_number": "413-796-6821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTTODICARLO",
        "first_name": "JOSEPHINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2011-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "54977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3001857",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.