SCOTT S MIRICK PA
NPI 1780138495
Physician Assistant - Surgical in Lebanon, NH

Q: What is Scott Mirick's NPI number?

The NPI number for Scott Mirick is 1780138495. It was assigned to this individual provider in the NPPES registry on August 10, 2016. The provider is also known as John Scott Shaddy.

Q: What is Scott Mirick's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Scott Mirick was last updated on September 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 10, 2016PECOS EnrolledAccepts Medicare Assignment

1 MEDICAL CENTER DR, LEBANON, NH 03756(603) 650-8537 Get Directions Write a Review

NPPES record last updated: September 18, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 18, 2019, Aug 29, 2016, Aug 10, 2016 (3 updates tracked since 2016).

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About Scott S Mirick Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SCOTT S MIRICK PA (NPI 1780138495) is an individual surgical provider in Lebanon, New Hampshire, licensed in New Hampshire (1179) and active in the NPI registry since August 2016. He is enrolled in Medicare PECOS, is affiliated with Mary Hitchcock Memorial Hospital, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1780138495

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameSCOTT S MIRICKCredential: PA

Location Address1 MEDICAL CENTER DRLebanon, NH 03756-0001

Mailing Address1 Medical Center DrLebanon, NH 03756-0001

Phone(603) 650-8537

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateAugust 10, 2016

Last NPPES UpdateSeptember 18, 20193 updates tracked since enumeration

✔ NPI 1780138495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in NH · 1179

1 MEDICAL CENTER DR, Lebanon, NH 03756

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Other Names 1

Former Name (1)John Scott Shaddy

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Scott S Mirick Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8426346685

PECOS Enrollment IDI20161004002363

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

240 services229 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

15 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mary Hitchcock Memorial Hospital

Acute Care Hospitals · Lebanon, NH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number300003

Location1 Medical Center DriveLebanon, NH 03756 · Grafton County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JANICE M BRENNAN APRN

Nurse Practitioner (Family)

1 MEDICAL CENTER DR, DHMC DEPARTMENT OF OCCUPATION MEDICINE
LEBANON, NH 03756

Grafton County (603) 560-5000

MS. SHELLEY GRACE BENSON R.PH.

Pharmacist (Oncology)

1 MEDICAL CENTER DR
LEBANON, NH 03756

Grafton County (603) 650-5417

ELIAS LOUKAS M.D.

Internal Medicine

1 MEDICAL CENTER DR, DHMC SECTION OF HOSPITAL MEDICINE
LEBANON, NH 03756

Grafton County (603) 650-8380

SARAH S SEO MD

Otolaryngology

1 MEDICAL CENTER DR, OTOLARYNGOLOGY
LEBANON, NH 03756

Grafton County (603) 650-8123

DR. SRINIVAS J. IVATURY MD

Colon & Rectal Surgery

1 MEDICAL CENTER DR, COLON & RECTAL SURGERY DEPARTMENT
LEBANON, NH 03756

Grafton County (603) 650-8113

TIMOTHY EARLEY D.O.

Student in an Organized Health Care Education/Training Program

1 MEDICAL CENTER DR
LEBANON, NH 03756

Grafton County (201) 694-0663

HANNAH ELIZABETH FOOTE BENSIMHON M.D.

Internal Medicine (Cardiovascular Disease)

1 MEDICAL CENTER DR
LEBANON, NH 03756

Grafton County (603) 650-5000

EMILE JOSEPH HASAN M.D.

Student in an Organized Health Care Education/Training Program

1 MEDICAL CENTER DR
LEBANON, NH 03756

Grafton County (603) 650-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Scott Mirick's NPI number?

The NPI number for Scott Mirick is 1780138495. It was assigned to this individual provider in the NPPES registry on August 10, 2016. The provider is also known as John Scott Shaddy.

Where is Scott Mirick located?

Scott Mirick practices at 1 Medical Center Dr, Lebanon, NH 03756. The listed phone number is (603) 650-8537.

What is Scott Mirick's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Scott Mirick enrolled in Medicare?

Yes. Scott Mirick is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Scott Mirick accept?

Health plans from Ambetter from NH Healthy Families, Anthem Blue Cross and Blue Sheld and Anthem Blue Cross and Blue Shield list Scott Mirick as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Scott Mirick affiliated with any hospitals?

According to CMS data, Scott Mirick is affiliated with Mary Hitchcock Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Scott Mirick was last updated on September 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.