Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Scott R. Wysowski, PA-C

Individual provider Physician Assistant · NPI 1770693640

Scott R. Wysowski, PA-C is a Physician Assistant in Fort Worth, Texas. Qualified in 2003, 23 years ago. Practices with Dallas Medical Specialists, PLLC, a 85-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
23
Licensed in
TX
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4501 Heritage Trace Pkwy Ste 101
Fort Worth, TX 76244-8941
Phone: (817) 481-2121
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2535 Ira E Woods Ave, Grapevine, TX 76051-3930 — (817) 481-2121

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA04750 (TX)

Record details

NPI number1770693640
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 30, 2006
Last updated in NPPESJanuary 4, 2022
Certification dateApril 27, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Dallas Medical Specialists, Pllc — 85 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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