Individual provider Active NPI

Scott Alan Phillips, PA-C

  • Physician Assistant
  • Tyler, TX
National Provider Identifier
1669722393
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA07893 Issued in TX
Practice address
5777 New Copeland Rd
Suite 100
Tyler, TX 75703-3905
Phone
(903) 561-9255
Fax
(903) 561-0034
NPI assigned
Sep 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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 PA07893 TX Primary

Addresses

Primary practice location

5777 New Copeland Rd
Suite 100
Tyler, TX 75703-3905

Mailing address

5777 New Copeland Rd
Suite 100
Tyler, TX 75703-3905
Phone (903) 561-9255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120926000302 TX Practitioner - Physician Assistant 7214186881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Arthritis and Rheumatology 5 clinicians

Practice addresses (Care Compare)

5777 New Copeland Rd
Suite 100
Tyler, TX 75703-3905
Phone (903) 561-9255

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

Merit-based Incentive Payment System (MIPS)

Final score
97.86 of 100Reported as group
Quality
95.73
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
57.1 of 100Reported as group
Quality
0
Promoting interoperability
100
Improvement activities
40
Cost
56.99

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA07893TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tyler Radiology Associates PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sphillips355614@ahs.direct-ci.com
  • Direct secure messaging: scott.phillips.p1@direct.texasarthritis.nextgenshare.com

Organizations & group practices 2

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 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": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1669722393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5777 NEW COPELAND RD",
            "address_2": "SUITE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033905",
            "telephone_number": "903-561-9255",
            "fax_number": "903-561-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 NEW COPELAND RD",
            "address_2": "SUITE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033905",
            "telephone_number": "903-561-9255",
            "fax_number": "903-561-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SCOTT",
        "middle_name": "ALAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-10",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.