KEVIN J SCULLY (MD) – Pediatric Endocrinology Physician, NPI 1770978363
Pediatric Endocrinology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,245 PEDIATRIC MEDICINE in MA
Provider Addresses for KEVIN J SCULLY (MD)
300 Longwood Ave
Boston, MA 021155724
Phone: (617) 355-6000
Type: Location
8 SCHODUK LN
BRUNSWICK, ME 040119519
Phone: (207) 729-9654
Type: Mailing
22 BRAMHALL ST
PORTLAND, ME 041023134
Phone: (207) 662-0111
Type: Location
117 ELLENFIELD ST STE 101
PROVIDENCE, RI 029054541
Phone: (401) 444-6779
Type: Mailing
593 EDDY ST
PROVIDENCE, RI 029034923
Phone: (401) 444-6195
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-06-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210611000571 | I | Endocrinology | MA | TBD |
| I20220615002731 | I | Pediatric Medicine | RI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 02115)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| A N E S T H E S I O L O G Y | RI | |
| E N D O C R I N O L O G Y | RI | |
| - | RI | |
| Pain Management | RI | |
| Hematology/Oncology, Internal Medicine | RI | |
| Gastroenterology, Pediatric Medicine | RI | |
| N E U R O L O G Y | RI | |
| Internal Medicine | RI | |
| - | RI | |
| N E U R O L O G Y | RI |
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