MR. SCOTT ALAN SOUTHERLAND P.A.
NPI 1639492804
Physician Assistant in Winfield, IL

Q: What is Scott Southerland's NPI number?

The NPI number for Scott Southerland is 1639492804. It was assigned to this individual provider in the NPPES registry on March 2, 2010.

Q: What is Scott Southerland's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Scott Southerland was last updated on February 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 02, 2010PECOS EnrolledAccepts Medicare Assignment

25 N WINFIELD RD, WINFIELD, IL 60190(630) 232-0280 Get Directions Write a Review

NPPES record last updated: February 15, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 15, 2022, Jun 1, 2021 (2 updates tracked since 2021).

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About Mr. Scott Alan Southerland P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. SCOTT ALAN SOUTHERLAND P.A. (NPI 1639492804) is an individual physician assistant in Winfield, Illinois, licensed in Illinois (085006027) and active in the NPI registry since March 2010. He is enrolled in Medicare PECOS, is affiliated with Northwestern Medicine Mchenry, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1639492804

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. SCOTT ALAN SOUTHERLANDCredential: P.A.

Location Address25 N WINFIELD RDWinfield, IL 60190-1379

Mailing Address4683 Mcgill CtHoover, AL 35226-6000 · (205) 335-8688

Phone(630) 232-0280

Sole ProprietorNo

Medical School CMSOtherGraduated 2009

Enumeration DateMarch 2, 2010

Last NPPES UpdateFebruary 15, 20222 updates tracked since enumeration

NPPES CertifiedFebruary 15, 2022

✔ NPI 1639492804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in IL · 085006027✔ Licensed in AL · TA1704

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License 695 (AL)

25 N WINFIELD RD, Winfield, IL 60190

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Scott Alan Southerland P.a. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648456301

PECOS Enrollment IDI20161102001687

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northwestern Medicine Mchenry

Acute Care Hospitals · Mchenry, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140116

Location4201 Medical Center DriveMchenry, IL 60050 · Mc Henry County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60190 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$93.02 typical visit price

range $59.81 – $181.38

Typical copayment $23.25 (range $14.95 – $45.34)

Most-billed visit code 99203

Established Patient

$74.38 typical visit price

range $19.15 – $147.12

Typical copayment $18.59 (range $4.78 – $36.78)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSEPH RAYMOND SCHNEIDER MD

Surgery (Vascular Surgery)

25 N WINFIELD RD, SUITE 201
WINFIELD, IL 60190

Dupage County (630) 933-4487

JESSICA LASAK BERNARDI APN

Nurse Practitioner