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Individual provider Active NPI

Scot R McKenna, M.D., P.C.

  • Plastic Surgery Physician
  • South Abington Township, PA
National Provider Identifier
1841269982
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD054788-L Issued in PA
Practice address
631 Northern Blvd
South Abington Township, PA 18411-9025
Phone
(570) 340-6920
Fax
(570) 340-6923
NPI assigned
Mar 14, 2006
Last updated
Dec 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MD054788-L PA Primary

Addresses

Primary practice location

631 Northern Blvd
South Abington Township, PA 18411-9025

Mailing address

631 Northern Blvd FL 2
South Abington Township, PA 18411-9025
Phone (570) 340-6920

Other identifiers 4

IdentifierTypeStateIssuer
2159444OtherPAAETNA
0017435930003MedicaidPA
518350OtherPABLUE CROSS BLUE SHIELD
51516OtherPAGEISINGER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060103000727 PA Practitioner - Plastic and Reconstructive Surgery 3375565427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

29 Woodlands Dr
Waymart, PA 18472-9366
Phone (570) 488-5250

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy15
Melanoma (skin cancer) excision34
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth51
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD054788-LPAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scot R. McKenna, M.D., P.C. Plastic Surgery CurrentSince Oct 25, 1999 Accepting new patients

Locations

1140 Quincy Ave
Scranton, PA 18510
Phone (570) 347-4420

1736 Sanderson Ave
Scranton, PA 18509
Phone (570) 340-6920

631 Northern Blvd
South Abington Township, PA 18411
Phone (570) 340-6920

631 Northern Blvd
Ste 2
South Abington Township, PA 18411
Phone (570) 340-6920

29 Woodlands Dr
Waymart, PA 18472
Phone (570) 253-5202

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 32

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1841269982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 NORTHERN BLVD FL 2",
            "city": "SOUTH ABINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184119025",
            "telephone_number": "570-340-6920",
            "fax_number": "570-340-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 NORTHERN BLVD",
            "city": "SOUTH ABINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184119025",
            "telephone_number": "570-340-6920",
            "fax_number": "570-340-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "SCOT",
        "middle_name": "R",
        "credential": "M.D., P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD054788-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2159444",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017435930003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "518350",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "51516",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Abington Township, PA

Sources for this page

Verify at the official NPI Registry.