BRENDEN G TULLY PA
NPI 1720765969
Physician Assistant in Ashtabula, OH

Q: What is Brenden Tully's NPI number?

The NPI number for Brenden Tully is 1720765969. It was assigned to this individual provider in the NPPES registry on June 29, 2023.

Q: What is Brenden Tully'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 Brenden Tully was last updated on October 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 June 29, 2023PECOS EnrolledAccepts Medicare Assignment

2420 LAKE AVE, ASHTABULA, OH 44004(440) 997-2262 Get Directions Write a Review

NPPES record last updated: October 10, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Brenden G Tully Pa NPPES

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

BRENDEN G TULLY PA (NPI 1720765969) is an individual physician assistant in Ashtabula, Ohio, licensed in Ohio (50.008422RX) and active in the NPI registry since June 2023. He is enrolled in Medicare PECOS, is affiliated with Summa Western Reserve Hospital, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1720765969

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameBRENDEN G TULLYCredential: PA

Location Address2420 LAKE AVEAshtabula, OH 44004-4954

Mailing Address411 Castle Rock RdBrookfield, OH 44403-8603 · (330) 413-7913

Phone(440) 997-2262

Sole ProprietorYes

Medical School CMSOtherGraduated 2023

Enumeration DateJune 29, 2023

Last NPPES UpdateOctober 10, 2023

NPPES CertifiedOctober 10, 2023

✔ NPI 1720765969 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in OH · 50.008422RX

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.

2420 LAKE AVE, Ashtabula, OH 44004

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

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

Brenden G Tully Pa 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 ID3971959149

PECOS Enrollment IDI20231024002114

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Drainage of fluid from abdominal cavity using imaging guidance 49083

This procedure involves removing excess fluid from your abdominal cavity, which can relieve discomfort. A specialist uses imaging technology to guide a thin needle into the right spot. The fluid is then drained out safely.

27 services15 patients

Removal of tunneled central venous tube 36589

A tunneled central venous tube removal is a procedure to take out a long, thin tube that was previously placed in a large vein in your body. This tube helps deliver medication or nutrition. The removal is usually quick and done under local anesthesia.

18 services18 patients

Hospital Affiliations CMS Care Compare

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

Summa Western Reserve Hospital

Acute Care Hospitals · Cuyahoga Falls, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360150

Location1900 23rd StreetCuyahoga Falls, OH 44223 · Summit County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44004 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

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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.

HELEN K LEE CRNA

Nurse Anesthetist, Certified Registered