Active NPI
Kathryn Lyn Scully, PA-C
- Physician Assistant
- Fairview, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- OA006347
- Practice address
- 7287 W Ridge Rd
Fairview, PA 16415 - Phone
- (814) 877-2360
- Fax
- (814) 877-3561
- NPI assigned
- Oct 15, 2020
- Last updated
- Jul 25, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA061933 | PA | |
| Physician Assistant | 363A00000X | OA006347 | PA | Primary |
Addresses
Primary practice location
7287 W Ridge Rd
Fairview, PA 16415
Mailing address
7287 W Ridge Rd
Fairview, PA 16415-1130
Phone (814) 877-2360
Other practice location 1
2060 N Pearl St
North East, PA 16428-1999
Phone (814) 877-7711
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1098405700001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3406 Peach St
Erie, PA 16508-2740
Phone (814) 877-5381
7287 W Ridge Rd
Primary Care Partners
Fairview, PA 16415-1130
Phone (814) 877-2360
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.89 of 100
- Quality
- 65.8
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.83
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OA006347 | PA | MD | Physician Assistant |
| MA061933 | PA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Franklin Pediatric Associates, P.C. | Past | Accepting new patients |
Interoperability endpoints
- kathryn.l.scully@upmcdirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Erie, PA
- NPI 1174520654
-
- Pediatrics Physician
- Franklin, PA
- NPI 1578595559
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Erie, PA
- NPI 1861435042
-
- General Acute Care Hospital
- Erie, PA
- NPI 1487647590
-
- General Acute Care Hospital
- Erie, PA
- NPI 1538207394
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721865600000",
"number": "1861090359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7287 W RIDGE RD",
"city": "FAIRVIEW",
"state": "PA",
"postal_code": "164151130",
"telephone_number": "814-877-2360",
"fax_number": "814-877-7715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7287 W RIDGE RD",
"city": "FAIRVIEW",
"state": "PA",
"postal_code": "16415",
"telephone_number": "814-877-2360",
"fax_number": "814-877-3561"
}
],
"practiceLocations": [
{
"address_1": "2060 N Pearl St",
"address_purpose": "LOCATION",
"city": "North East",
"state": "PA",
"postal_code": "164281999",
"country_code": "US",
"telephone_number": "814-877-7711",
"fax_number": "814-877-7715",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SCULLY",
"first_name": "KATHRYN",
"middle_name": "LYN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-15",
"last_updated": "2024-07-25",
"certification_date": "2024-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA061933",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "OA006347",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1098405700001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fairview, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.