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MR. TIMOTHY SHAWN SCANLON JR. PA-C
NPI 1730147919
Physician Assistant in Kettering, OH

Active since May 04, 2006PECOS Enrolled
3535 SOUTHERN BLVD, KETTERING, OH 45429(937) 395-8166 Get Directions Write a Review

NPPES record last updated: May 6, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 6, 2020, Aug 7, 2019, Mar 17, 2018 (3 updates tracked since 2018).

About Mr. Timothy Shawn Scanlon Jr. Pa-c NPPES

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

MR. TIMOTHY SHAWN SCANLON JR. PA-C (NPI 1730147919) is an individual physician assistant in Kettering, Ohio, licensed in Ohio (50.001117) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1730147919
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. TIMOTHY SHAWN SCANLON JR.Credential: PA-C
Location Address3535 SOUTHERN BLVDKettering, OH 45429-1221
Mailing Address3131 Newmark Dr Ste 220Miamisburg, OH 45342-5400 · (937) 436-4658 · Fax (937) 436-4984
Phone(937) 395-8166
Sole ProprietorNo
Enumeration DateMay 4, 2006
Last NPPES UpdateMay 6, 20203 updates tracked since enumeration
NPPES CertifiedMay 6, 2020
✔ NPI 1730147919 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
License✔ Licensed in OH · 50.001117
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 · MedicalTaxonomy 363AM0700X · License 2540 (AZ)
3535 SOUTHERN BLVD, Kettering, OH 45429
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Other Identifiers 1

Medicaid0078665OH

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 (PECOS)

Mr. Timothy Shawn Scanlon Jr. Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45429 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.

RAGHEED KATKHUDA MD
Pediatrics (Neonatal-Perinatal Medicine)
3535 SOUTHERN BLVD
KETTERING, OH 45429
Montgomery County (937) 752-2304
ANNEMARIE ROSE UNDERWOOD PA-C
Physician Assistant
3535 SOUTHERN BLVD
DAYTON, OH 45429
Montgomery County (937) 395-8166
SYLVIA POLENAKOVIK M.D.
Internal Medicine
3535 SOUTHERN BLVD
DAYTON, OH 45429
Montgomery County (937) 395-6665
SUSAN KAY ZANN RNFS
Registered Nurse (Registered Nurse First Assistant)
3535 SOUTHERN BLVD
KETTERING, OH 45429
Montgomery County (937) 395-8608
SWATHI DATLA M.B.B.S.
Hospitalist
3535 SOUTHERN BLVD
KETTERING, OH 45429
Montgomery County (937) 395-6665
DR. LOREN ANN NALLU MD
Pediatrics (Neonatal-Perinatal Medicine)
3535 SOUTHERN BLVD
KETTERING, OH 45429
Montgomery County (937) 752-2304
DR. JEREMY LAWTON CHAPMAN D.O.
Hospitalist
3535 SOUTHERN BLVD
KETTERING, OH 45429
Montgomery County (937) 395-6665
DR. RAHUL RAO DO
Radiology (Diagnostic Radiology)
3535 SOUTHERN BLVD
DAYTON, OH 45429
Montgomery County (937) 395-8627

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Scanlon's NPI number?

The NPI number for Timothy Scanlon is 1730147919. It was assigned to this individual provider in the NPPES registry on May 4, 2006.

Where is Timothy Scanlon located?

Timothy Scanlon practices at 3535 Southern Blvd, Kettering, OH 45429. The listed phone number is (937) 395-8166.

What is Timothy Scanlon's specialty?

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

Is Timothy Scanlon enrolled in Medicare?

Yes. Timothy Scanlon is registered in the Medicare PECOS enrollment system.

What insurance does Timothy Scanlon accept?

Health plans from CareSource list Timothy Scanlon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Timothy Scanlon was last updated on May 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.