Organization Active NPI

Scott Donofrio MD

  • Psychiatry Physician
  • Pennington, NJ
National Provider Identifier
1821461609
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA08893200 Issued in NJ
Legal business name
SCOTT DONOFRIO MD
Practice address
32 N Main St
Pennington, NJ 08534-2230
Phone
(609) 474-4660
NPI assigned
Nov 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Authorized official

Name
Scott Donofrio, M.D.
Title
Director
Phone
(575) 418-8109

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A0401X 25MA08893200 NJ
Behavioral Neurology & Neuropsychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084B0040X 25MA08893200 NJ
Neurodevelopmental Disabilities PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0005X 25MA08893200 NJ
Psychosomatic Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0015X 25MA08893200 NJ
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 25MA08893200 NJ Primary
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X 25MA08893200 NJ
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X 25MA08893200 NJ
Geriatric Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0805X 25MA08893200 NJ

Addresses

Primary practice location

32 N Main St
Pennington, NJ 08534-2230

Mailing address

32 N Main St
Pennington, NJ 08534-2230
Phone (609) 474-4660

Other identifiers 1

IdentifierTypeStateIssuer
33905258MedicaidNM

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452729600000",
    "number": "1821461609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 N MAIN ST",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342230",
            "telephone_number": "609-474-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 N MAIN ST",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342230",
            "telephone_number": "609-474-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT DONOFRIO MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-03",
        "last_updated": "2016-01-14",
        "status": "A",
        "authorized_official_last_name": "DONOFRIO",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "575-418-8109",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NJ",
            "license": "25MA08893200",
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "NJ",
            "license": "25MA08893200",
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "NJ",
            "license": "25MA08893200",
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "NJ",
            "license": "25MA08893200",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA08893200",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NJ",
            "license": "25MA08893200",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "25MA08893200",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NJ",
            "license": "25MA08893200",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33905258",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.