Individual provider Active NPI

Mary C. Scoigletti, APRN

  • Family Nurse Practitioner
  • Yorkville, IL
National Provider Identifier
1891884169
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209004264 Issued in IL
Practice address
100 W Veterans Pkwy
Yorkville, IL 60560-1827
Phone
(866) 825-3227
Fax
(484) 351-3800
NPI assigned
Oct 12, 2006
Last updated
Oct 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11001512 FL
Family Nurse Practitioner 363LF0000X 209004264 IL Primary

Addresses

Primary practice location

100 W Veterans Pkwy
Yorkville, IL 60560-1827

Mailing address

161 Washington St
Eight Tower Bridge, Suite 1400
Conshohocken, PA 19428-2083
Phone (866) 825-3227

Other practice location 1

22829 State Road 54
Land O Lakes, FL 34639-5227
Phone (813) 915-5459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20041210000023 IL Practitioner - Nurse Practitioner 5597722603 Reassigns benefits to 2 organizations
I20190906001329 FL Practitioner - Nurse Practitioner 5597722603 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Radial Health Southeast LLC CurrentSince Apr 1, 2020 Accepting new patients
Florida Hospital Physician Group Inc Family CurrentSince Oct 14, 2019 Accepting new patients
Radial Health SC CurrentSince Mar 10, 2018 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 28, 2019 Accepting new patients
CH MH Services (Az), LLC Past Accepting new patients

Locations

22829 State Road 54
Land O Lakes, FL 34639
Phone (813) 949-0464

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

26895 Network Pl
Chicago, IL 60673

29373 Network Pl
Chicago, IL 60673

77 N Airlite St
Elgin, IL 60123
Phone (847) 622-3407

Interoperability endpoints

  • Direct secure messaging: mary.scoigletti@489656322949124.direct.elationemr.com

Organizations & group practices 5

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1891884169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 WASHINGTON ST",
            "address_2": "EIGHT TOWER BRIDGE, SUITE 1400",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282083",
            "telephone_number": "866-825-3227",
            "fax_number": "484-351-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W VETERANS PKWY",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605601827",
            "telephone_number": "866-825-3227",
            "fax_number": "484-351-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22829 State Road 54",
            "address_purpose": "LOCATION",
            "city": "Land O Lakes",
            "state": "FL",
            "postal_code": "346395227",
            "country_code": "US",
            "telephone_number": "813-915-5459",
            "fax_number": "813-345-8172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOIGLETTI",
        "first_name": "MARY",
        "middle_name": "C.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11001512",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209004264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorkville, IL

Sources for this page

Verify at the official NPI Registry.