NPIMap

Individual provider Active NPI

John Scully, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1285182360
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone
(815) 219-6743
NPI assigned
Sep 16, 2016
Last updated
Oct 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

1800 W Charleston Blvd
Las Vegas, NV 89102-2329

Mailing address

9300 W Sunset Rd
Las Vegas, NV 89148-4844

Other practice location 1

5380 S Rainbow Blvd Ste 306
Las Vegas, NV 89118-1880
Phone (702) 888-1188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, AZ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161208002438 NV Practitioner - Physician Assistant 9638459639 Reassigns benefits to 6 organizations
I20200728001471 AZ Practitioner - Physician Assistant 9638459639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunrise Mountainview Multispecialty Clinics LLCGroup PAC ID 1759469711, 64 clinicians
Marc J Kayem M D IncGroup PAC ID 2264428937, 2 clinicians
Khavkin Clinic, PLLCGroup PAC ID 7517111545, 2 clinicians

Practice addresses (Care Compare)

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 731-8115

5380 S Rainbow Blvd
Suite 306
Las Vegas, NV 89118-1880
Phone (310) 777-7879

9300 W Sunset Rd
Las Vegas, NV 89148-4844
Phone (702) 916-8431

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eds-I Homansky Practices of Nevada PC Physician Assistant CurrentSince Jul 1, 2019 Accepting new patients
Fremont Emergency Services Scherr LTD Physician Assistant CurrentSince Aug 1, 2020 Accepting new patients
Fremont Emergency Services Scherr LTD Physician Assistant CurrentSince Aug 1, 2020 Accepting new patients
Eds-I Homansky Practices of Nevada PC Physician Assistant CurrentSince Jul 1, 2019 Accepting new patients
Fremont Emergency Services Scherr LTD Physician Assistant Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

3186 S Maryland Pkwy
Ste 410
Las Vegas, NV 89109

3325 S Fort Apache Rd
Las Vegas, NV 89117
Phone (702) 962-0500

9300 W Sunset Rd
Las Vegas, NV 89148
Phone (702) 880-2100

7207 Aliante Pkwy
North Las Vegas, NV 89084
Phone (702) 962-5100

360 S Lola Ln
Pahrump, NV 89048
Phone (775) 751-7500

Interoperability endpoints

  • Direct secure messaging: john.scully@hca3.eclinicaldirectplus.com

Organizations & group practices 12

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1285182360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 W SUNSET RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022329",
            "telephone_number": "815-219-6743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5380 S Rainbow Blvd Ste 306",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891181880",
            "country_code": "US",
            "telephone_number": "702-888-1188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCULLY",
        "first_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-16",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.