Michael D Scott, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036100296 Issued in IL

Practice address

5404 Fairview Ave
Downers Grove, IL 60515-5332

Phone

(630) 921-1606

NPI assigned

Jan 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mscott@yourcarecommunity.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.

• App of Illinois Ed PLLC

  • Emergency Medicine Physician
  • Waukegan, IL
  • NPI 1053860080
  Medicare reassignment NPD
• Integritas Emergency Physician Services, LLC

  • Emergency Medicine Physician
  • Carbondale, IL
  • NPI 1790128817
  Medicare reassignment NPD
• Memorial Hospital

  • Critical Access Hospital
  • Chester, IL
  • NPI 1851390132
  Medicare reassignment NPD
• Sarah Bush Lincoln Health Center

  • General Acute Care Hospital
  • Mattoon, IL
  • NPI 1669564662
  Medicare reassignment NPD
• Statera Health Care, LLC

  • Emergency Medicine Physician
  • Harrisburg, IL
  • NPI 1043874449
  Medicare reassignment NPD
• Sarah Bush Lincoln Health Center

  • Rural Health Clinic/Center
  • Greenville, IL
  • NPI 1811858970
  NPD
• Sarah Bush Lincoln Health Center

  • Critical Access Hospital
  • Vandalia, IL
  • NPI 1912988734
  NPD

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242172800000",
    "number": "1790763571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5404 FAIRVIEW AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155332",
            "telephone_number": "630-921-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5404 FAIRVIEW AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155332",
            "telephone_number": "630-921-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2009-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036100296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100296",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100296-4",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "3932056",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacklyn Samantha Schur, MS SLP
• Nicole Ann Schwab
• Nicole Scott Sauer, DPT
• Tiffany J Scott-Horton, PHARM.D.
• Lee Anne A Scott, RN
• Kaelyn Nichole Scull, OTR/L
• MHD Adeeb Sebai
• Patrick Sebastian
• Erin M. Sebo, APN-CNP
• Second Stories Therapeutic Interventions

• Emergency Medicine Physician in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.