Individual provider Active NPI

Scott Michael Quigley, OD

  • Optometrist
  • Springboro, OH
National Provider Identifier
1902941180
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1735 Issued in SC
Practice address
80 Andover Dr
Springboro, OH 45066-8101
Phone
(937) 748-8328
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5358 OH
Optometrist 152W00000X 1735 SC Primary

Addresses

Primary practice location

80 Andover Dr
Springboro, OH 45066-8101

Mailing address

80 Andover Dr
Springboro, OH 45066-8101
Phone (937) 748-8328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201208001841 SC Practitioner - Optometry 0042448284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bergelt Optometric LLCGroup PAC ID 5092007666, 15 clinicians

Practice addresses (Care Compare)

2110 Bells Hwy
Walterboro, SC 29488-6978
Phone (843) 524-5212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
5358OHMDClinical Neuropsychologist
1735SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bergelt Optometric LLC Optometrist CurrentSince Dec 1, 2020 Accepting new patients

Locations

265 Sea Island Pkwy
Beaufort, SC 29907
Phone (843) 489-3213

2672 David H McLeod Blvd
Florence, SC 29501
Phone (843) 773-2758

10820 Kings Rd
Myrtle Beach, SC 29572
Phone (843) 449-0508

2795 North Rd
Orangeburg, SC 29118
Phone (803) 531-2746

9880 Dorchester Rd
Summerville, SC 29485
Phone (843) 851-0280

2110 Bells Hwy
Walterboro, SC 29488
Phone (843) 539-1555

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.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1902941180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ANDOVER DR",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450668101",
            "telephone_number": "937-748-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ANDOVER DR",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450668101",
            "telephone_number": "937-748-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIGLEY",
        "first_name": "SCOTT",
        "middle_name": "MICHAEL",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5358",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springboro, OH

Sources for this page

Verify at the official NPI Registry.