Scott R. Wysowski, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04750 Issued in TX

Practice address

4501 Heritage Trace Pkwy Ste 101
Fort Worth, TX 76244-8941

Phone

(817) 481-2121

NPI assigned

Aug 30, 2006

Last updated

Jan 4, 2022By the provider in NPPES

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

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dallas Medical Specialists, PLLCGroup PAC ID 3072895788, 86 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical City Plano Hospital, Plano, TX, CCN 450651

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Dallas Medical Specialists, PLLC

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1508217811
  Medicare reassignment Care Compare group
• Lonestar Provider Network

  dba Dallas Medical Specialists

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1194765586
  NPD (past)
• Orthotx, PLLC

  dba Arlington Orthopedic Associates, PLLC

  • Orthopaedic Surgery Physician
  • Arlington, TX
  • NPI 1336134469
  NPD (past)
• Orthotx, PLLC

  dba North Texas Orthopedics & Spine Center

  • Durable Medical Equipment & Medical Supplies
  • Fort Worth, TX
  • NPI 1831919679
  NPD (past)

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

• Columbia Medical Center of Plano Subsidiary LP

  dba Medical City Plano

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1699726406
  Care Compare affiliation

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1770693640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 IRA E WOODS AVE",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513930",
            "telephone_number": "817-481-2121",
            "fax_number": "817-488-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 HERITAGE TRACE PKWY STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448941",
            "telephone_number": "817-481-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2535 Ira E Woods Ave",
            "address_purpose": "LOCATION",
            "city": "Grapevine",
            "state": "TX",
            "postal_code": "760513930",
            "country_code": "US",
            "telephone_number": "817-481-2121",
            "fax_number": "817-488-4493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYSOWSKI",
        "first_name": "SCOTT",
        "middle_name": "R.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-01-04",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SCOTT.WYSOWSKI@hca7.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "2535 Ira E Woods Ave",
            "city": "Grapevine",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760513930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristin Wylie, MS, CCC-SLP
• Mark W Wylie, M.D.
• Amber Wynn
• Lee A Wynne, WHNP
• Mallory Wyrick, PA-C
• Pamela Anna Wysuph
• Katy Kourtney Wyszynski, DO, MS
• Xavier Wellness Center LLC
• Ann Xavier
• Christy Ann Xavier, PHARMD

• Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.