SCOTT R. WYSOWSKI PA-C
NPI 1770693640
Physician Assistant in Fort Worth, TX

Active since August 30, 2006PECOS EnrolledAccepts Medicare Assignment
4501 HERITAGE TRACE PKWY STE 101, FORT WORTH, TX 76244(817) 481-2121 Get Directions Write a Review

NPPES record last updated: January 4, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 4, 2022, Nov 18, 2019, Oct 30, 2018 and 1 more (4 updates tracked since 2016).

About Scott R. Wysowski Pa-c NPPES

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

SCOTT R. WYSOWSKI PA-C (NPI 1770693640) is an individual physician assistant in Fort Worth, Texas, licensed in Texas (PA04750) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Medical City Plano, and maintains a secondary practice location in Grapevine.

NPPES Registry Identity

NPI1770693640
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameSCOTT R. WYSOWSKICredential: PA-C
Location Address4501 HERITAGE TRACE PKWY STE 101Fort Worth, TX 76244-8941
Mailing Address2535 Ira E Woods AveGrapevine, TX 76051-3930 · (817) 481-2121 · Fax (817) 488-4493
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateAugust 30, 2006
Last NPPES UpdateJanuary 4, 20224 updates tracked since enumeration
NPPES CertifiedApril 27, 2020
NPI 1770693640 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 TX · PA04750
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.

4501 HERITAGE TRACE PKWY STE 101, Fort Worth, TX 76244

Secondary Practice Location 1

Location 12535 Ira E Woods AveGrapevine, TX 76051-3930 · Phone (817) 481-2121 · Fax (817) 488-4493

Accepted 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

Scott R. Wysowski Pa-c 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 ID3577540541
PECOS Enrollment IDI20060425000723
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.

Medical City Plano

Acute Care Hospitals · Plano, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450651
Location3901 W 15th StPlano, TX 75075 · Collin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76244 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
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
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 4

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

Occupational Therapist
4501 HERITAGE TRACE PKWY STE 101
FORT WORTH, TX 76244
Durable Medical Equipment & Medical Supplies
4501 HERITAGE TRACE PKWY STE 101, DBA NORTH TEXAS ORTHOPEDICS & SPINE CENTER
FORT WORTH, TX 76244
Physical Therapy Assistant
4501 HERITAGE TRACE PKWY STE 101
FORT WORTH, TX 76244
Durable Medical Equipment & Medical Supplies
4501 HERITAGE TRACE PKWY STE 101
FORT WORTH, TX 76244

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 Scott Wysowski's NPI number?

The NPI number for Scott Wysowski is 1770693640. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Where is Scott Wysowski located?

Scott Wysowski practices at 4501 Heritage Trace Pkwy Ste 101, Fort Worth, TX 76244. The listed phone number is (817) 481-2121.

What is Scott Wysowski's specialty?

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

Is Scott Wysowski enrolled in Medicare?

Yes. Scott Wysowski is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Scott Wysowski accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 5 other insurers list Scott Wysowski 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.

Is Scott Wysowski affiliated with any hospitals?

According to CMS data, Scott Wysowski is affiliated with Medical City Plano.

When was this NPI record last updated?

The NPPES record for Scott Wysowski was last updated on January 4, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.