Individual provider Active NPI

Scott Roberts, MS, PA-C

  • Physician Assistant
  • Danvers, MA
National Provider Identifier
1720528334
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA6024 Issued in MA
Practice address
104 Endicott St
Ste. 100
Danvers, MA 01923-3623
Phone
(978) 745-6601
NPI assigned
Mar 1, 2017
Last updated
Mar 1, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA6024 MA Primary

Addresses

Primary practice location

104 Endicott St
Ste. 100
Danvers, MA 01923-3623

Mailing address

104 Endicott St
Ste. 100
Danvers, MA 01923-3623
Phone (978) 745-6601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD, DC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200403002773 DE Practitioner - Physician Assistant 7012293814 Reassigns benefits to 1 organization
I20230110002461 MD Practitioner - Physician Assistant 7012293814 Reassigns benefits to 1 organization
I20230110002623 DC Practitioner - Physician Assistant 7012293814 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries LLC Current Accepting new patients
American Current Care PA CurrentSince Oct 16, 2023 Accepting new patients
American Current Care P.a. CurrentSince Oct 16, 2023 Accepting new patients
American Current Care, PA. CurrentSince Oct 16, 2023 Accepting new patients
MNR Industries, LLC CurrentSince Dec 16, 2022 Accepting new patients
MNR Industries, LLC CurrentSince Dec 16, 2022 Accepting new patients
Christiana Care Quality Partners PastSince Aug 1, 2021 Accepting new patients

Locations

1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

1419 Knecht Ave
Halethorpe, MD 21227
Phone (410) 247-9595

4451 Parliament Pl
Ste G
Lanham, MD 20706
Phone (301) 459-9113

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1720528334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ENDICOTT ST",
            "address_2": "STE. 100",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233623",
            "telephone_number": "978-745-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ENDICOTT ST",
            "address_2": "STE. 100",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233623",
            "telephone_number": "978-745-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SCOTT",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.