Individual provider Active NPI

Vincent C Scoglietti III, MD

  • Surgery Physician
  • Carrollton, GA
National Provider Identifier
1740467398
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
68788 Issued in GA
Practice address
706 Dixie St Ste 130
Carrollton, GA 30117-3859
Phone
(770) 812-5886
Fax
(770) 838-1027
NPI assigned
Jan 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 68788 GA Primary

Addresses

Primary practice location

706 Dixie St Ste 130
Carrollton, GA 30117-3859

Mailing address

706 Dixie St Ste 130
Carrollton, GA 30117-3859
Phone (770) 812-5886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20130925000689 GA Practitioner - General Surgery 1658515044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Georgia School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

706 Dixie St
Suite 130
Carrollton, GA 30117-3819
Phone (770) 812-5866

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy21
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68788GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Medical Group Inc CurrentSince Aug 1, 2024 Accepting new patients
Carrollton Surgical Group, P. a. Surgery PastSince Aug 1, 2024 Accepting new patients
TMC Children's Healthcare of West Georgia Past Accepting new patients
West Georgia Health Physicians Inc Surgery Past Accepting new patients

Locations

100 Greenway Blvd
Fl 2
Carrollton, GA 30117
Phone (770) 838-8710

706 Dixie St
Ste 130
Carrollton, GA 30117
Phone (770) 812-5866

706 Dixie St
Carrollton, GA 30117
Phone (770) 836-9697

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

Interoperability endpoints

  • Direct secure messaging: vscoglietti134958@directwellstar.org
  • Direct secure messaging: vincent.scoglietti@westgahealth.gadirect.net

Organizations & group practices 4

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 3

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": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1740467398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 DIXIE ST STE 130",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173859",
            "telephone_number": "770-812-5886",
            "fax_number": "770-838-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 DIXIE ST STE 130",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173859",
            "telephone_number": "770-812-5886",
            "fax_number": "770-838-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOGLIETTI",
        "first_name": "VINCENT",
        "middle_name": "C",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-25",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "68788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.