Individual provider Active NPI

Shannon L Scolaro, NP

  • Nurse Practitioner
  • Brockton, MA
National Provider Identifier
1891756037
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
212661 Issued in MA
Practice address
235 N Pearl St
Brockton, MA 02301-1794
Phone
(508) 427-3000
NPI assigned
Mar 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 212661 MA
Nurse Practitioner 363L00000X 212661 MA Primary

Addresses

Primary practice location

235 N Pearl St
Brockton, MA 02301-1794

Mailing address

960 Massachusetts Ave Ste 2
Boston, MA 02118-2690
Phone (617) 414-4505

Other practice location 1

32 Jyra Ln
North Easton, MA 02356-2738
Phone (508) 272-6014

Other identifiers 3

IdentifierTypeStateIssuer
NP2812OtherMABLUE CROSS
0391841MedicaidMA
39159OtherMAHARVARD PILGRIM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20060208000414 MA Practitioner - Nurse Practitioner 7012922362 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
212661MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
BMC Affiliated Physicians, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince Jul 29, 2014 Accepting new patients
Steward Medical Group, Inc CurrentSince Jul 29, 2014 Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

765 Attucks Ln
Hyannis, MA 02601
Phone (508) 957-0200

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

Interoperability endpoints

  • Direct secure messaging: sscolaro259846@direct.bmc.masshiway.net
  • Direct secure messaging: shannon.scolaro.1@2017.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1891756037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690",
            "telephone_number": "617-414-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011794",
            "telephone_number": "508-427-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32 Jyra Ln",
            "address_purpose": "LOCATION",
            "city": "North Easton",
            "state": "MA",
            "postal_code": "023562738",
            "country_code": "US",
            "telephone_number": "508-272-6014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOLARO",
        "first_name": "SHANNON",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "212661",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "212661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "NP2812",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0391841",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "39159",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.