Individual provider Active NPI

Randal H. Colquitt, M.D.

  • Anesthesiology Physician
  • Las Vegas, NV
National Provider Identifier
1144298076
Registry record updated Jan 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
7431 Issued in NV
Practice address
2450 W Charleston Blvd
Las Vegas, NV 89102-2179
Phone
(702) 877-8661
Fax
(702) 877-5140
NPI assigned
Mar 8, 2006
Last updated
Jan 13, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 7431 NV Primary

Addresses

Primary practice location

2450 W Charleston Blvd
Las Vegas, NV 89102-2179

Mailing address

PO Box 15645
Las Vegas, NV 89114-5645
Phone (702) 877-8661

Other identifiers 3

IdentifierTypeStateIssuer
1144298076MedicaidUT
1144298076MedicaidNV
2019654MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110210000653 NV Practitioner - Anesthesiology 3375723117 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.7 of 100Reported as group
Quality
82.63
Promoting interoperability
100
Improvement activities
40
Cost
83.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group Rhodes P C CurrentSince Dec 1, 2019 Accepting new patients
Southwest Medical Associates Inc. CurrentSince Aug 27, 2020 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Dec 1, 2019 Accepting new patients
Southwest Medical Associates, Inc CurrentSince Aug 27, 2020 Accepting new patients
Optum Medical Group Rhodes P C Anesthesiology Current Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Nov 10, 2013 Accepting new patients
Summit Anesthesia Consultants, Inc Anesthesiology Past Accepting new patients

Locations

58 N Pecos Rd
Henderson, NV 89074
Phone (702) 822-2000

2450 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8660

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

Interoperability endpoints

  • Direct secure messaging: rcolquitt117993@westdirect.optum.com

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1144298076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "702-877-8661",
            "fax_number": "702-877-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022179",
            "telephone_number": "702-877-8661",
            "fax_number": "702-877-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLQUITT",
        "first_name": "RANDAL",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "7431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144298076",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144298076",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019654",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.