Individual provider Active NPI

Gregory Scallon, P.A.

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1891722302
Registry record updated Jan 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2563 Issued in AZ
Practice address
3411 N 5TH Ave Ste 209
Phoenix, AZ 85013-3812
Phone
(602) 789-0344
Fax
(602) 789-8389
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2018

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 2563 AZ Primary

Addresses

Primary practice location

3411 N 5TH Ave Ste 209
Phoenix, AZ 85013-3812

Mailing address

3411 N 5TH Ave Ste 209
Phoenix, AZ 85013-3812
Phone (602) 789-0344

Other identifiers 1

IdentifierTypeStateIssuer
634370MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040517001320 AZ Practitioner - Physician Assistant 2062402381 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.72 of 100Reported as apm
Quality
72.97
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2563AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Emergency Physicians Inc Past Accepting new patients
Team Physicians of Arizona PC Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gehgscall@yourcarecommunity.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516060800000",
    "number": "1891722302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 N 5TH AVE STE 209",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133812",
            "telephone_number": "602-789-0344",
            "fax_number": "602-789-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 N 5TH AVE STE 209",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133812",
            "telephone_number": "602-789-0344",
            "fax_number": "602-789-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCALLON",
        "first_name": "GREGORY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2018-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "634370",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.