Individual provider Active NPI

Scott Waller, M.D.

  • Orthopaedic Surgery Physician
  • Shelton, CT
National Provider Identifier
1720011547
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
037651 Issued in CT
Practice address
2 Trap Falls Rd Ste 404
Shelton, CT 06484-7622
Phone
(203) 734-7900
Fax
(203) 513-3269
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 037651 CT
Orthopaedic Surgery Physician 207X00000X 037651 CT Primary

Addresses

Primary practice location

2 Trap Falls Rd Ste 404
Shelton, CT 06484-7622

Mailing address

2 Trap Falls Rd Ste 404
Shelton, CT 06484-7622
Phone (203) 734-7900

Other practice location 1

220 Main St Ste 1F
Oxford, CT 06478-1065
Phone (203) 734-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20050824000284 CT Practitioner - Orthopedic Surgery 4880625433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
New York Medical College, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Orthopaedic Specialists, LLC.Group PAC ID 1951299122, 12 clinicians
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians

Practice addresses (Care Compare)

2 Trap Falls Rd
Suite 404
Shelton, CT 06484-7622
Phone (203) 734-7900

555 Bridgeport Ave
Shelton, CT 06484-4749
Phone (203) 922-1773

Hospital & facility affiliations

  • Griffin Hospital Hospital, Derby, CT, CCN 070031

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
037651CTMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Orthopaedic Specialists LLC Orthopaedic Surgery CurrentSince Jun 13, 2010 Accepting new patients
Valley Orthopaedic Specialists, LLC CurrentSince Jun 13, 2010 Accepting new patients
Physical Therapy of Southern Connecticut, P.C. Past Accepting new patients
Orthocare Specialists ,LLC Past Accepting new patients
Valley Orthopaedic Specialists, LLC Past Accepting new patients
B .Glenn Blair DPM P.C. PastSince Jan 1, 1996 Accepting new patients
Fairfield Sports and Spine LLC PastSince Jun 26, 2024 Accepting new patients

Locations

111 Wakelee Ave
Ansonia, CT 06401
Phone (203) 308-2781

1275 Post Rd
Ste 208
Fairfield, CT 06824
Phone (203) 255-0891

220 Main St
Oxford, CT 06478

144 Oxford Rd
Oxford, CT 06478
Phone (203) 734-7900

220 Main St
Ste 1F
Oxford, CT 06478
Phone (203) 734-7900

2 Trap Falls Rd
Shelton, CT 06484
Phone (203) 816-6424

2 Trap Falls Rd
Ste 405
Shelton, CT 06484
Phone (203) 929-1954

2 Trap Falls Rd
Ste 404
Shelton, CT 06484
Phone (203) 734-7900

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.70818

Organizations & group practices 7

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 1

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1720011547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 TRAP FALLS RD STE 404",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064847622",
            "telephone_number": "203-734-7900",
            "fax_number": "203-513-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TRAP FALLS RD STE 404",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064847622",
            "telephone_number": "203-734-7900",
            "fax_number": "203-513-3269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Main St Ste 1F",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "CT",
            "postal_code": "064781065",
            "country_code": "US",
            "telephone_number": "203-734-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLER",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "CT",
            "license": "037651",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CT",
            "license": "037651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

Verify at the official NPI Registry.