Individual provider Active NPI

Sydney Scott, PA-C

  • Physician Assistant
  • Waterville, ME
National Provider Identifier
1851760094
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C5-0001017 Issued in DE
Practice address
244 Kennedy Memorial Dr Ste 102
Waterville, ME 04901-4538
Phone
(207) 861-8030
Fax
(207) 861-8317
NPI assigned
Sep 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C5-0001017 DE Primary

Addresses

Primary practice location

244 Kennedy Memorial Dr Ste 102
Waterville, ME 04901-4538

Mailing address

244 Kennedy Memorial Dr Ste 102
Waterville, ME 04901-4538
Phone (207) 861-8030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, PA, ME3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20151118000067 DE Practitioner - Physician Assistant 3072813369 Reassigns benefits to 1 organization
I20160217000580 PA Practitioner - Physician Assistant 3072813369 Reassigns benefits to 1 organization
I20220120000581 ME Practitioner - Physician Assistant 3072813369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ophelia Medical Group FL PAGroup PAC ID 7810398534, 103 clinicians

Practice addresses (Care Compare)

161 Cecil B Moore Ave
Apt 204
Philadelphia, PA 19122-3243
Phone (215) 585-2144

500 Forest Ave
Suite 1C
Portland, ME 04101-1523
Phone (215) 585-2144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C5-0001017DEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc CurrentSince Apr 13, 2019 Accepting new patients
Ophelia Medical Group, P.C. PastSince Mar 22, 2020 Accepting new patients
Sebasticook Valley Health PastSince Feb 6, 2022 Accepting new patients

Locations

640 S State St
#3055
Dover, DE 19901
Phone (302) 480-1688

640 S State St
Dover, DE 19901
Phone (302) 744-4700

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1851760094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 KENNEDY MEMORIAL DR STE 102",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014538",
            "telephone_number": "207-861-8030",
            "fax_number": "207-861-8317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 KENNEDY MEMORIAL DR STE 102",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014538",
            "telephone_number": "207-861-8030",
            "fax_number": "207-861-8317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "SYDNEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0001017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

Verify at the official NPI Registry.