Active NPI
Clinton Herwin Scott Jr., DPM
- Podiatrist
- Gary, IN
National Provider Identifier
1750360137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 07000990A
- Practice address
- 720 W 5TH Ave
Gary, IN 46402-1808 - Phone
- (609) 440-8714
- Fax
- (269) 469-9240
- NPI assigned
- Jan 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 07000990A | IN | Primary |
Addresses
Primary practice location
720 W 5TH Ave
Gary, IN 46402-1808
Mailing address
3903 Portage Rd
Suite C #161
South Bend, IN 46628-4431
Phone (609) 440-8714
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000339432 | Other | IN | ANTHEM |
| 200305000 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- New York College of Podiatric Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
720 W 5TH Ave
Gary, IN 46402-1808
Phone (219) 718-4735
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 19 |
| Removal of nail tissue | 33 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07000990A | IN | MD | Podiatrist |
Interoperability endpoints
- cscott8560@themethodisthospitals.direct-ci.com
Organizations & group practices 1
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.
-
- Foot & Ankle Surgery Podiatrist
- Gary, IN
- NPI 1487813580
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gary, IN
- NPI 1467504555
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782086400000",
"number": "1750360137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3903 PORTAGE RD",
"address_2": "SUITE C #161",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466284431",
"telephone_number": "609-440-8714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 W 5TH AVE",
"city": "GARY",
"state": "IN",
"postal_code": "464021808",
"telephone_number": "609-440-8714",
"fax_number": "269-469-9240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "CLINTON",
"middle_name": "HERWIN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-12",
"last_updated": "2026-06-22",
"certification_date": "2026-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IN",
"license": "07000990A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000339432",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200305000",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gary, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.