KEVIN P SCULLY PAC
NPI 1730199563
Physician Assistant in Tyler, TX
NPI Status: Active since August 08, 2006
Contact Information
6210 S BROADWAY AVE
TYLER, TX
ZIP 75703
Phone: (903) 579-2718
Fax: (903) 579-2793
- Individual
- Male
- Physician Assistant
- Accepts Insurance
About KEVIN SCULLY
This page provides the complete NPI Profile along with additional information for Kevin Scully, a primary care provider established in Tyler, Texas with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1730199563 assigned on August 2006. The practitioner's primary taxonomy code is 363A00000X with license number PA03374 (TX). The provider is registered as an individual and his NPI record was last updated 7 years ago.
- NPI
- 1730199563
- Provider Name
- KEVIN P SCULLY PAC
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 6210 S BROADWAY AVE TYLER, TX 75703
- Location Phone
- (903) 579-2718
- Location Fax
- (903) 579-2793
- Mailing Address
- PO BOX 99371 FORT WORTH, TX 76199
- Mailing Phone
- (682) 885-1855
- Mailing Fax
- (903) 579-2793
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-08-2006
- Last Update Date
- 08-17-2018
- Code Navigator
A primary care provider (PCP) like Kevin Scully sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Secondary Locations
- 837 S Fleishel Ave
Tyler, TX 75701
(903) 526-0450
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- PA03374
- License State
- TX
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Bronze Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Standard - HMO
- UHC Gold Standard $0 Indiv Ded ($0 Virtual Urgent Care) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
- UHC Silver Standard - HMO
- UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Silver Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 192484704 | MEDICAID (05) | TX | |
| 192484701 | MEDICAID (05) | TX |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 3 | 0 | 1 | 9 | 9 | 5 | 6 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 6 | 0 | 2 | 9 | 18 | 5 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 6 + 0 + 2 + 9 + 1 + 8 + 5 + 1 + 2 + 24 = 67 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 67 = 3 | 3 | ||||||||
The NPI number 1730199563 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 12 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1235167586 | LAUREN LYNN HORNELL MD Individual | Family Medicine | 6210 S BROADWAY AVE TYLER, TX 75703 (903) 579-2700 |
| 1083641559 | DOUGLAS FREDERICK JOHNSTON DO Individual | Family Medicine | 6210 S BROADWAY AVE TYLER, TX 75703 (903) 579-2700 |
| 1861426041 | SMITH EMERGENCY MEDICINE ASSOCIATES PA Organization | Emergency Medicine | 6210 S BROADWAY AVE TYLER, TX 75703 (800) 893-9698 |
| 1326082892 | EAST TEXAS MEDICAL CENTER HEALTHCARE ASSOCIATES Organization | Emergency Medicine | 6210 S BROADWAY AVE TYLER, TX 75703 (903) 579-2800 |
| 1699101832 | AMANDA S JENKINS WHNP Individual | Nurse Practitioner (Family) | 6210 S BROADWAY AVE TYLER, TX 75703 (903) 579-2700 |
| 1649364241 | NANCY CAROLINE MCRAE-VOGLER M.D. Individual | Pediatrics | 6210 S BROADWAY AVE TYLER, TX 75703 (903) 579-2700 |
| 1003588963 | ANNA ELISE FENTON NP Individual | Nurse Practitioner | 6210 S BROADWAY AVE TYLER, TX 75703 (903) 579-2700 |
| 1497424832 | TRACY RODRIGUEZ NP Individual | Nurse Practitioner | 6210 S BROADWAY AVE TYLER, TX 75703 (903) 579-2700 |
| 1124339437 | PAUL ANDREW KYSER MD Individual | Family Medicine | 6210 S BROADWAY AVE TYLER, TX 75703 (903) 579-2700 |
| 1194110924 | BRITTANY B. SHIPES APRN Individual | Nurse Practitioner (Family) | 6210 S BROADWAY AVE TYLER, TX 75703 (035) 792-7009 |
| 1528683554 | DR. KYLE ANDREW WEBSTER MD Individual | Emergency Medicine | 6210 S BROADWAY AVE TYLER, TX 75703 (903) 579-2800 |
| 1669642088 | DR. AMY ROBERTS HUFF FNP Individual | Nurse Practitioner (Family) | 6210 S BROADWAY AVE TYLER, TX 75703 (903) 579-2700 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1730199563, enumerated in the NPI registry as an "individual" on August 08, 2006
The provider is located at 6210 S Broadway Ave Tyler, Tx 75703 and the phone number is (903) 579-2718
The provider's speciality is Physician Assistant with taxonomy code 363A00000X
The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on August 08, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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