Individual provider Active NPI

Michael D Scott, PA-C

  • Surgical Physician Assistant
  • Cheyenne, WY
National Provider Identifier
1114007028
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
208 Issued in WY
Practice address
4017 Rawlins St
Cheyenne, WY 82001-1800
Phone
(307) 635-2562
Fax
(307) 637-2867
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA208 WY
Surgical Physician Assistant 363AS0400X PA-2238 CO
Surgical Physician Assistant 363AS0400X 208 WY Primary

Addresses

Primary practice location

4017 Rawlins St
Cheyenne, WY 82001-1800

Mailing address

4136B Laramie Street
Cheyenne, WY 82001-1969
Phone (307) 637-2800

Other identifiers 3

IdentifierTypeStateIssuer
970026026OtherWYRAIL ROAD MEDICARE
111303800MedicaidWY
311196OtherWYBLUE CROSS BLUE SHIELD

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mscott5192@direct.crmcwy.org Direct Memorial Hospital of Laramie County
Direct Messaging Address mscott5192@direct.crmcwy.org Health Information Exchange (HIE) Memorial Hospital of Laramie County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070822001128 WY Practitioner - Physician Assistant 0143312165 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cheyenne Regional Physicians Group LLCGroup PAC ID 2961403639, 101 clinicians

Practice addresses (Care Compare)

2301 House Ave
Suite 507
Cheyenne, WY 82001-3176
Phone (307) 635-2562

4116 Laramie St
Cheyenne, WY 82001-1969
Phone (307) 635-7961

Hospital & facility affiliations

  • Cheyenne Regional Medical Center Hospital, Cheyenne, WY, CCN 530014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
208WYMDIntellectual & Developmental Disabilities Psychologist
PA208WYMDPhysician Assistant
PA-2238COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medi Horizons Inc Past Accepting new patients
Wyoming Orthopedic and Sports Medicine, LLC Physician Assistant Past Accepting new patients
Cheyenne Children'S Clinic, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mscott5192@direct.crmcwy.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1114007028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4136B LARAMIE STREET",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820011969",
            "telephone_number": "307-637-2800",
            "fax_number": "307-637-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4017 RAWLINS ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820011800",
            "telephone_number": "307-635-2562",
            "fax_number": "307-637-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "PA208",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA-2238",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WY",
            "license": "208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "970026026",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111303800",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "311196",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mscott5192@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Memorial Hospital of Laramie County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mscott5192@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Memorial Hospital of Laramie County",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.