Individual provider Active NPI

Cornelius Hugh Scannell, MD

  • Pulmonary Disease Physician
  • Wilton Manors, FL
National Provider Identifier
1912963281
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME90980 Issued in FL
Practice address
1402 NE 26TH St
Medical Multi Specialty GRP
Wilton Manors, FL 33305-1322
Phone
(954) 749-1616
Fax
(954) 749-1639
NPI assigned
Apr 25, 2006
Last updated
Jan 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME90980 FL Primary

Addresses

Primary practice location

1402 NE 26TH St
Medical Multi Specialty GRP
Wilton Manors, FL 33305-1322

Mailing address

1402 NE 26TH St
Wilton Manors, FL 33305-1322
Phone (954) 749-1616

Other identifiers 1

IdentifierTypeStateIssuer
920512385813MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050613000906 FL Practitioner - Internal MedicinePractitioner - Pulmonary Disease 7810931680 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME90980FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital, Inc CurrentSince Feb 1, 2011 Accepting new patients
Holy Cross Senior Services Inc CurrentSince Feb 27, 2019 Accepting new patients
Holy Cross Hospital Inc Pulmonary Disease CurrentSince Feb 1, 2011 Accepting new patients

Locations

1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

8391 W Oakland Park Blvd
Sunrise, FL 33351
Phone (954) 335-6925

1402 NE 26th St
Wilton Manors, FL 33305
Phone (954) 563-3767

2675 N Andrews Ave
Wilton Manors, FL 33311
Phone (954) 563-4711

Interoperability endpoints

  • Direct secure messaging: cscannell2023449@direct.trinity-health.org

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1912963281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 NE 26TH ST",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051322",
            "telephone_number": "954-749-1616",
            "fax_number": "954-749-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 NE 26TH ST",
            "address_2": "MEDICAL MULTI SPECIALTY GRP",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051322",
            "telephone_number": "954-749-1616",
            "fax_number": "954-749-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANNELL",
        "first_name": "CORNELIUS",
        "middle_name": "HUGH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME90980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "920512385813",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton Manors, FL

Sources for this page

Verify at the official NPI Registry.