Michael John Scott, PSY.D., ABN

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY5960 Issued in FL

Practice address

414 SE 3Rd Ter
Dania Beach, FL 33004-4708

Phone

(786) 202-6273

NPI assigned

Dec 22, 2006

Last updated

Mar 26, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Heartshare Wellness, LTD.

  • Public Health or Welfare Agency
  • Brooklyn, NY
  • NPI 1487895371
  NPD (past)

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1912062704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 SE 3RD TER",
            "city": "DANIA BEACH",
            "state": "FL",
            "postal_code": "330044708",
            "telephone_number": "786-202-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 SE 3RD TER",
            "city": "DANIA BEACH",
            "state": "FL",
            "postal_code": "330044708",
            "telephone_number": "786-202-6273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 7th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352223211",
            "country_code": "US",
            "telephone_number": "205-963-7682",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PSY.D., ABN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "NY011875-1",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": "13211",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY5960",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": "13211",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "13211",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYPACT APIT",
            "identifier": "13211",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Sanchez, LMHC
• Yaima Santos Alfonso
• Thomas Anthony Schopler, DDS
• Sciberras Internal Medicine Inc
• Andrea Sciberras, D.O.
• Serisa LLC (Right at Home)
• Ian Sharp, PHD
• Justin Shemesh, D.O.
• Aleksey Petrovich Shubin, MD
• Timothy Shuttleworth, PHARMACIST

• Clinical Neuropsychologist in Dania Beach, FL
• Providers in Dania Beach, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.