Mr Timothy Shawn Scanlon Jr, PA-C - Medicare Physician Assistant in Kettering, OH

Mr Timothy Shawn Scanlon Jr, PA-C is a medicare enrolled "Physician Assistant" in Kettering, Ohio. His current practice location is 3535 Southern Blvd, Kettering, Ohio. You can reach out to his office (for appointments etc.) via phone at (937) 395-8166.

Mr Timothy Shawn Scanlon Jr is licensed to practice in Ohio (license number 50.001117) 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 1730147919.

Contact Information

Mr Timothy Shawn Scanlon Jr, PA-C
3535 Southern Blvd,
Kettering, OH 45429-1221
(937) 395-8166
Not Available



Provider's Profile

Full NameMr Timothy Shawn Scanlon Jr
GenderMale
SpecialityPhysician Assistant
Location3535 Southern Blvd, Kettering, Ohio
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1730147919
  • Provider Enumeration Date: 05/04/2006
  • Last Update Date: 05/06/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 8224161260
  • Enrollment ID: I20130312000318

Medical Identifiers

Medical identifiers for Mr Timothy Shawn Scanlon Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1730147919NPI-NPPES
0078665MedicaidOH

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical 2540 (Arizona)Secondary
363A00000XPhysician Assistant 50.001117 (Ohio)Primary

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. Mr Timothy Shawn Scanlon Jr 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 AddressPractice Location Address
Mr Timothy Shawn Scanlon Jr, PA-C
3131 Newmark Dr Ste 220,
Miamisburg, OH 45342-5400

Ph: (937) 436-4658
Mr Timothy Shawn Scanlon Jr, PA-C
3535 Southern Blvd,
Kettering, OH 45429-1221

Ph: (937) 395-8166

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Physician Assistant Nurses in Kettering, OH

Milena Menchaca, PA
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 3535 Southern Blvd, Kettering, OH 45429
Phone: 937-395-8166    
Annabeth Pruett Barry, PA-C, MBA
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 424 E Stroop Rd Unit B, Kettering, OH 45429
Phone: 937-562-2300    Fax: 937-562-2302
Miss Kathryn Paige Combs, MPAS, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 3535 Southern Blvd, Kettering, OH 45429
Phone: 937-395-8166    
Michael D Kelley, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 3535 Southern Blvd, Kettering, OH 45429
Phone: 937-395-6665    Fax: 937-395-6668
Marie Therese Mualla Oram, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 3700 Southern Blvd Ste 300, Kettering, OH 45429
Phone: 937-643-9299    Fax: 937-643-2343
Lydia Nicole Little, PA-C
Physician Assistant
Medicare: May Accept Medicare Assignments
Practice Location: 3535 Southern Blvd, Kettering, OH 45429
Phone: 937-643-9299    Fax: 937-643-2343
Mr. David Evans, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 3533 Southern Blvd Ste 2250, Kettering, OH 45429
Phone: 937-534-0330    Fax: 937-522-8995

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