Active NPI
Scott Donofrio MD
- Psychiatry Physician
- Pennington, NJ
National Provider Identifier
1821461609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 25MA08893200
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | 25MA08893200 | NJ | |
| Behavioral Neurology & Neuropsychiatry Physician | 2084B0040X | 25MA08893200 | NJ | |
| Neurodevelopmental Disabilities Physician | 2084P0005X | 25MA08893200 | NJ | |
| Psychosomatic Medicine Physician | 2084P0015X | 25MA08893200 | NJ | |
| Psychiatry Physician | 2084P0800X | 25MA08893200 | NJ | Primary |
| Addiction Psychiatry Physician | 2084P0802X | 25MA08893200 | NJ | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 25MA08893200 | NJ | |
| Geriatric Psychiatry Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33905258 | Medicaid | NM |
National Provider Directory
National Provider DirectoryNPI 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.