DR. SCOTT JOLLY (DO) – Emergency Medicine Physician, NPI 1790783694
Emergency Medicine Physician
Main info
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. SCOTT JOLLY (DO)
1320 W Main St
Newark, OH 430551822
Phone: (220) 564-7153
Type: Location
Licking Memorial Hospital, 1320, West Main Street, Newark, Licking County, Ohio, 43055, United States
NEWARK, OH 430551822
Phone: (220) 564-4151
Fax: (220) 564-7153
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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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: 2020-07-07
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 |
|---|---|---|---|---|
| I20091124000367 | I | Emergency Medicine | OH | TBD |
| I20200707002888 | I | Emergency Medicine | TX | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 124 | 123 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 84 | 76 | $0 |
| 99285 | Emergency department visit with high level of medical decision making | 79 | 79 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 52 | 52 | $0 |
| 93042 | Electrocardiogram (ecg) 1 to 3 leads with review by physician only | 11 | 11 | $0 |
Insurance plans in this area (ZIP 43055)
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