Scott Trevor Micallef, DMD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

DN1858373 Issued in MA

Practice address

333 Ricciuti Dr Apt 1307
Quincy, MA 02169-6295

Phone

(908) 839-8313

NPI assigned

May 30, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1972161420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 RICCIUTI DR APT 1307",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021696295",
            "telephone_number": "908-839-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 RICCIUTI DR APT 1307",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021696295",
            "telephone_number": "908-839-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICALLEF",
        "first_name": "SCOTT",
        "middle_name": "TREVOR",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "DN1858373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Metelka
• Metrix Healthcare Solutions
• Amanda Metzger, MD
• Andrea Rochelle Meyers, MSW,LICSW
• Rachael Jean Mezzetti, FNP
• Michael V. Sinopoli OD PC
• Ereny Micheal
• Suzeline Michel Paul
• Betca Michel
• Jon C Michel, LMHC LADC-1

• Student in an Organized Health Care Education/Training Program in Quincy, MA
• Providers in Quincy, MA by specialty
• Student in an Organized Health Care Education/Training Program in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.