Provider Demographics
NPI:1598751323
Name:MASTERSON, SCOTT ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ROBERT
Last Name:MASTERSON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CORTLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079
Mailing Address - Country:US
Mailing Address - Phone:603-365-7548
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8092208100000X, 2081P2900X
MA70585208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA23-00008OtherUHC
NH0102646Y0MA01OtherANTHEM
MA0003756OtherNHP
MA3052303Medicaid
MA23-00143OtherEVERCARE
MA715271OtherTHP
MAJ08600OtherBCBS
MA0035350-001OtherCIGNA
MA80317OtherHPHC
MA23592OtherFCHP
NH3003093Medicaid
MA4374984OtherAETNA
MA23-00008OtherUHC
MA23592OtherFCHP
MA0003756OtherNHP