Scott S Mirick, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

1179 Issued in NH

Practice address

1 Medical Center Dr
Lebanon, NH 03756-0001

Phone

(603) 650-8537

NPI assigned

Aug 10, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• John Scott Shaddy Former name

Medicare fee-for-service enrollment

Enrolled in NH

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 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

Merit-based Incentive Payment System (MIPS)

Final score

79.66 of 100Reported as apm

Quality

53.51

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

83.39 of 100Reported as group

Quality

72.51

Promoting interoperability

100

Improvement activities

40

Cost

55.45

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smirick240102@direct.dartmouth-hitchcock.org

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.

• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1023092053
  Medicare reassignment Care Compare group NPD
• Dartmouth-Hitchcock Clinic

  • Internal Medicine Physician
  • Lebanon, NH
  • NPI 1548210198
  Medicare reassignment NPD
• Alice Peck Day Memorial Hospital

  • Critical Access Hospital
  • Lebanon, NH
  • NPI 1003803495
  Medicare reassignment
• Alice Peck Day Memorial Hospital

  • Family Medicine Physician
  • Lebanon, NH
  • NPI 1073569810
  NPD
• Alice Peck Day Memorial Hospital

  • Urgent Care Clinic/Center
  • Lebanon, NH
  • NPI 1942002274
  NPD
• Alice Peck Day Memorial Hospital

  • Podiatrist
  • Lebanon, NH
  • NPI 1942691829
  NPD
• Dartmouth-Hitchcock Clinic

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Keene, NH
  • NPI 1174176861
  NPD
• Mary Hitchcock Memorial Hospital

  • Psychiatric Hospital
  • Hampstead, NH
  • NPI 1699584219
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1023092053
  Care Compare affiliation
• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1629788237
  Care Compare affiliation

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1780138495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-8537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRICK",
        "first_name": "SCOTT",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-10",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NH",
            "license": "1179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "SHADDY",
            "middle_name": "SCOTT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret Min, MD
• Patricia L Min, MD
• Traci Lynne Mincey
• William E Minsinger, MD
• Anne Christine Miranowski, M.D.
• Manish Kumar Mishra, M.D.
• Shantum Misra, MD
• Lisa A Mistler, MD
• Denise M Mitchell, MS, CCC-S
• James P. Mithoefer, PA

• Surgical Physician Assistant in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Surgical Physician Assistant in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.

Verify at the official NPI Registry.