Individual provider Active NPI

Elizabeth Anne Scully, PA-C

  • Physician Assistant
  • Cleveland Heights, OH
National Provider Identifier
1528617149
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3376 E Fairfax Rd
Cleveland Heights, OH 44118-4208
Phone
(216) 645-9866
NPI assigned
Sep 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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 Primary

Addresses

Primary practice location

3376 E Fairfax Rd
Cleveland Heights, OH 44118-4208

Mailing address

3376 E Fairfax Rd
Cleveland Heights, OH 44118-4208
Phone (216) 645-9866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200221000678 OH Practitioner - Physician Assistant 7719314376 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716

3999 Richmond Rd
Beachwood, OH 44122-6046
Phone (216) 593-5500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Cleveland Medical Center Physician Assistant CurrentSince Mar 1, 2023 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Apr 3, 2023 Accepting new patients
University Hospitals Cleveland Medical Center CurrentSince Mar 1, 2023 Accepting new patients
Multicare Health System Physician Assistant Past Accepting new patients

Locations

33300 Cleveland Clinic Blvd
Avon, OH 44011
Phone (440) 686-0105

3909 Orange Pl
Ste 4300
Beachwood, OH 44122
Phone (216) 844-3009

3999 Richmond Rd
Cleveland, OH 44122
Phone (216) 293-8226

11100 Euclid Ave
Cleveland Heights, OH 44106

7007 Powers Blvd
Parma, OH 44129
Phone (440) 743-4000

Interoperability endpoints

  • Direct secure messaging: escully220520@ehrdirect.uhhospitals.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1528617149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3376 E FAIRFAX RD",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441184208",
            "telephone_number": "216-645-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3376 E FAIRFAX RD",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441184208",
            "telephone_number": "216-645-9866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLY",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland Heights, OH

Sources for this page

Verify at the official NPI Registry.