NPIMap

Individual provider Active NPI

Paul Blakely Scaddan, M.D.

  • Family Medicine Physician
  • Sebewaing, MI
National Provider Identifier
1912944737
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301076874 Issued in MI
Practice address
616 Unionville Rd
Sebewaing, MI 48759-1631
Phone
(989) 883-9088
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301076874 MI Primary

Addresses

Primary practice location

616 Unionville Rd
Sebewaing, MI 48759-1631

Mailing address

616 Unionville Rd
Sebewaing, MI 48759-1631
Phone (989) 883-9088

Other practice location 1

57 S Center St
Sebewaing, MI 48759-1414
Phone (989) 883-9656

Other identifiers 1

IdentifierTypeStateIssuer
142056OtherMIGLHP SHN NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pscaddan45590@direct.covenanthealthcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110425000126 MI Practitioner - Family Practice 1052596780 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scheurer HospitalGroup PAC ID 1456242296, shared by 10 NPIs, 49 clinicians

Practice addresses (Care Compare)

108 N Caseville Rd
Pigeon, MI 48755-9704

135 N Caseville Rd
Pigeon, MI 48755-9704
Phone (989) 453-3798

170 N Caseville Rd
Pigeion, MI 48755-9704

616 Unionville Rd
Sebewaing, MI 48759-1631
Phone (989) 883-9088

75 Buschlen Rd
Bad Axe, MI 48413-9177
Phone (989) 623-9300

Hospital & facility affiliations

  • Seasons Change Home Health Care Home health agency, Pigeon, MI, CCN 237462
  • A&D Health Care Professional Home health agency, Saginaw, MI, CCN 237186
  • Residential Home Health and Hospice Home health agency, Lapeer, MI, CCN 237495
  • McLaren Home Health Home health agency, Bay City, MI, CCN 237165
  • Covenant at Home Home health agency, Saginaw, MI, CCN 237431
  • A Change of Seasons Hospice, Inc. Hospice, Pigeon, MI, CCN 231676
  • Scheurer Hospital Hospital, Pigeon, MI, CCN 231310
  • Hills & Dales General Hospital Hospital, Cass City, MI, CCN 231316
  • Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222
  • Covenant Medical Center Hospital, Saginaw, MI, CCN 230070
  • McLaren Bay Region Hospital, Bay City, MI, CCN 230041
  • Scheurer Hospital Nursing home, CCN 23Z310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301076874MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scheurer Hospital Current Accepting new patients
Scheurer Hospital CurrentSince Aug 4, 2003 Accepting new patients
Scheurer Hospital CurrentSince Aug 4, 2003 Accepting new patients
Scheurer Hospital Past Accepting new patients
Scheurer Hospital Past Accepting new patients

Locations

170 N Caseville Rd
Pigeon, MI 48755
Phone (989) 453-3223

168 N Caseville Rd
Pigeon, MI 48755
Phone (989) 453-2141

108 N Caseville Rd
Pigeon, MI 48755
Phone (989) 453-7301

57 S Center St
Sebewaing, MI 48759
Phone (989) 883-9656

616 Unionville Rd
Sebewaing, MI 48759
Phone (989) 883-9088

Interoperability endpoints

  • Direct secure messaging: pscaddan45590@direct.covenanthealthcare.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
A Change of Seasons Hospice, Inc.Pigeon, MI, CCN 231676 Hospice Contracted Managing Employee Apr 12, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1912944737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 UNIONVILLE RD",
            "city": "SEBEWAING",
            "state": "MI",
            "postal_code": "487591631",
            "telephone_number": "989-883-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 UNIONVILLE RD",
            "city": "SEBEWAING",
            "state": "MI",
            "postal_code": "487591631",
            "telephone_number": "989-883-9088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 S Center St",
            "address_purpose": "LOCATION",
            "city": "Sebewaing",
            "state": "MI",
            "postal_code": "487591414",
            "country_code": "US",
            "telephone_number": "989-883-9656",
            "fax_number": "989-883-9537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCADDAN",
        "first_name": "PAUL",
        "middle_name": "BLAKELY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301076874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GLHP SHN NUMBER",
            "identifier": "142056",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pscaddan45590@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "616 Unionville Rd",
            "city": "Sebewaing",
            "state": "MI",
            "country_code": "US",
            "postal_code": "487591631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sebewaing, MI

Sources for this page

Verify at the official NPI Registry.