Individual provider Active NPI

Scott M. Credit, APRN

  • Family Nurse Practitioner
  • New London, CT
National Provider Identifier
1811976111
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3204 Issued in CT
Practice address
194 Howard St
New London, CT 06320-5544
Phone
(860) 444-3366
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 285443 MA
Family Nurse Practitioner 363LF0000X 3204 CT Primary

Addresses

Primary practice location

194 Howard St
New London, CT 06320-5544

Mailing address

99 Hawley Lane, FL. 3, CB-3427
Northeast Medical Group, Inc.
Stratford, CT 06614-1202
Phone (203) 502-4650

Other identifiers 2

IdentifierTypeStateIssuer
1811976111MedicaidCT
1811976111MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20050818000060 CT Practitioner - Nurse Practitioner 1456332683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

49 Sandy Desert Rd
Uncasville, CT 06382-1111
Phone (860) 862-7329

67 Sandy Desert Rd
Uncasville, CT 06382-1111
Phone (860) 464-3800

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 688-4242

95 Armory Rd
Stratford, CT 06614-1702
Phone (203) 384-3388

Hospital & facility affiliations

  • Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285443MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Conncare Inc Nurse Practitioner Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: scredit329560@direct.ynhh.org

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.

Hospital & facility affiliations 2

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1811976111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 HAWLEY LANE, FL. 3, CB-3427",
            "address_2": "NORTHEAST MEDICAL GROUP, INC.",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141202",
            "telephone_number": "203-502-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 HOWARD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205544",
            "telephone_number": "860-444-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREDIT",
        "first_name": "SCOTT",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "285443",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "3204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811976111",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811976111",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.