Individual provider Active NPI

Elyssa Nicole Scarnecchia

  • Family Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1780299115
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1029672 Issued in TX
Practice address
3101 Burnet Ave
Cincinnati, OH 45229-3014
Phone
(513) 357-7289
NPI assigned
Sep 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 1029672 TX Primary

Addresses

Primary practice location

3101 Burnet Ave
Cincinnati, OH 45229-3014

Mailing address

308 Holderrieth Blvd
Tomball, TX 77375-4536
Phone (281) 351-4911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20220805001929 TX Practitioner - Nurse Practitioner 2860874948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

308 Holderrieth Blvd
Tomball, TX 77375-4536
Phone (281) 351-4911

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1029672TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Houston Heart Center P.a. Single Specialty CurrentSince Jul 1, 2022 Accepting new patients
Northwest Houston Heart Center, P.a. Single Specialty Past Accepting new patients

Locations

425 Holderrieth Blvd
Ste 208
Tomball, TX 77375
Phone (281) 357-5515

308 Holderrieth Blvd
Tomball, TX 77375
Phone (281) 351-4911

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EHBEAA

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1780299115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 HOLDERRIETH BLVD",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773754536",
            "telephone_number": "281-351-4911",
            "fax_number": "281-351-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 BURNET AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293014",
            "telephone_number": "513-357-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARNECCHIA",
        "first_name": "ELYSSA",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-11",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1029672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.