Individual provider Active NPI

Scott Russell McGillivray, DNP, FNP-BC

  • Family Nurse Practitioner
  • Center Line, MI
National Provider Identifier
1720786130
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704307034 Issued in MI
Practice address
8569 George
Center Line, MI 48015-1733
Phone
(586) 246-5041
NPI assigned
Feb 16, 2023
Last updated
Feb 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704307034 MI Primary

Addresses

Primary practice location

8569 George
Center Line, MI 48015-1733

Mailing address

8569 George
Center Line, MI 48015-1733
Phone (586) 246-5041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TX2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20230913001148 MI Practitioner - Nurse Practitioner 6800250630 Reassigns benefits to 1 organization
I20240214001183 TX Practitioner - Nurse Practitioner 6800250630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.65 of 100Reported as group
Quality
68.3
Improvement activities
40
Cost
86.97

Merit-based Incentive Payment System (MIPS)

Final score
96.26 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
83.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Pintado Clinic CurrentSince Jan 16, 2024 Accepting new patients
DHHS PHS Naihs Crownpoint Hospital Current Accepting new patients
Thoreau Clinic CurrentSince Jan 16, 2024 Accepting new patients
Gastrointestinal Specialists PC CurrentSince Aug 15, 2023 Accepting new patients
Essential Anesthesia Services, PLC CurrentSince Aug 15, 2023 Accepting new patients

Locations

264 W Maple Rd
Ste 200
Troy, MI 48084
Phone (248) 273-9930

Organizations & group practices 5

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": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1720786130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8569 GEORGE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151733",
            "telephone_number": "586-246-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8569 GEORGE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151733",
            "telephone_number": "586-246-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGILLIVRAY",
        "first_name": "SCOTT",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704307034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Center Line, MI

Sources for this page

Verify at the official NPI Registry.