Kevin J Scully, MD in Providence, RI

Kevin J Scully, MD is a medicare enrolled "Pediatrics - Pediatric Endocrinology" physician in Providence, Rhode Island. His current practice location is 593 Eddy St, Providence, Rhode Island. You can reach out to his office (for appointments etc.) via phone at (401) 444-6195.

Kevin J Scully is licensed to practice in Rhode Island (license number MD18498) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1770978363.

Contact Information

	Kevin J Scully, MD
	593 Eddy St, Providence, RI 02903-4923
	(401) 444-6195
	Not Available

Map and Direction

Physician's Profile

Full Name	Kevin J Scully
Gender	Male
Speciality	Pediatrics - Pediatric Endocrinology
Location	593 Eddy St, Providence, Rhode Island
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1770978363
Provider Enumeration Date: 04/01/2015
Last Update Date: 06/03/2022

Medicare PECOS Information:

PECOS PAC ID: 8123332640
Enrollment ID: I20210611000571

Medical Identifiers

Medical identifiers for Kevin J Scully such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1770978363	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2080P0205X	Pediatrics - Pediatric Endocrinology	286562 (Massachusetts)	Secondary
2080P0205X	Pediatrics - Pediatric Endocrinology	MD18498 (Rhode Island)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kevin J Scully allows following entities to bill medicare on his behalf.

Entity Name	Lifespan Physician Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407116643 PECOS PAC ID: 2567455082 Enrollment ID: O20121026000023

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kevin J Scully is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kevin J Scully, MD 117 Ellenfield St Ste 101, Providence, RI 02905-4541 Ph: (401) 444-6779	Kevin J Scully, MD 593 Eddy St, Providence, RI 02903-4923 Ph: (401) 444-6195

Reviews and Comments

Pediatrics Doctors in Providence, RI

Sara Regan Ford, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1 Hoppin St, Coro Center Suite 304, Providence, RI 02903 Phone: 401-444-4612 Fax: 401-793-8831
Jennifer F Friedman, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 593 Eddy St, Lower Level, Providence, RI 02903 Phone: 401-444-4471 Fax: 401-444-3870
Jason Shapiro, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-8450 Fax: 401-444-5088
Dr. Mikhaela Monty, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-4471 Fax: 401-444-7574
Dale Steele, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Claverick 2, Providence, RI 02903 Phone: 401-854-2504 Fax: 401-854-2519
Chase B Samsel, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-8450 Fax: 401-444-5088
Adebimpe Olubusayo Adewusi, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 593 Eddy St, Porter 005, Providence, RI 02903 Phone: 401-444-2877 Fax: 401-444-3804

Kevin J Scully, MD - Medicare Pediatrics in Providence, RI