Thomas Scully, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

R9882 Issued in MO

Practice address

450 N New Ballas Rd
Suite 150N
Saint Louis, MO 63141

Phone

(314) 315-9914

NPI assigned

May 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Urology

Education

Indiana University School of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Lukes Urology, LLCGroup PAC ID 0749602712, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St. Lukes Urology, LLC

  • Urology Physician
  • Chesterfield, MO
  • NPI 1619505344
  Medicare reassignment Care Compare group NPD
• Neurosurgery and Neurology LLC

  • Specialist
  • Chesterfield, MO
  • NPI 1134291388
  NPD (past)
• Orthopedic Spine Center LLC

  • Orthopaedic Surgery of the Spine Physician
  • Saint Louis, MO
  • NPI 1730950155
  NPD (past)

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

• St. Lukes Episcopal-Presbyterian Hospital

  dba St. Luke's Hospital

  • General Acute Care Hospital
  • Chesterfield, MO
  • NPI 1346251543
  Care Compare affiliation

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1285692608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 DUNN RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630317928",
            "telephone_number": "314-315-9913",
            "fax_number": "314-872-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N NEW BALLAS RD",
            "address_2": "SUITE 150N",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-315-9914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10296 Big Bend Rd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631226582",
            "country_code": "US",
            "telephone_number": "314-315-9911",
            "fax_number": "314-686-4087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCULLY",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "R9882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "P00195684",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth B Scroggins, D.M.D.
• Stacey Scrogin, FNP
• Amber Scruton, R.N.
• Walter Robert Scull, M.ED., LPC
• Kristen Ann Scullin-Hartman, MD
• Camille Scurlock, AUD
• Tyrell Scurlock
• Monica A Scutariu, MD
• SE-Ren-I-Ty Health Plus
• SE-Ren-I-Ty Health Services LLC

• Urology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Urology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.