Active NPI
Nathan Scullion, MS, PA-C
- Physician Assistant
- Oakland, CA
National Provider Identifier
1538549324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA58383
- Practice address
- 4400 Harbord Dr
Oakland, CA 94618-2207 - Phone
- (510) 540-8200
- NPI assigned
- Jun 5, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA58383 | CA | Primary |
Addresses
Primary practice location
4400 Harbord Dr
Oakland, CA 94618-2207
Mailing address
4400 Harbord Dr
Oakland, CA 94618-2207
Phone (510) 540-8200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58383 | CA | MD | Oral and Maxillofacial Surgery (Dentist) |
| PA58383 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596672000000",
"number": "1538549324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 HARBORD DR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946182207",
"telephone_number": "510-540-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 HARBORD DR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946182207",
"telephone_number": "510-540-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCULLION",
"first_name": "NATHAN",
"credential": "MS, PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-05",
"last_updated": "2020-08-06",
"certification_date": "2020-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA58383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.