Scott Mitchel Kamilar, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP2868 Issued in MN

Practice address

1409 Willow St
Suite 300
Minneapolis, MN 55403-2269

Phone

(612) 870-1242

Fax

(612) 870-8077

NPI assigned

May 4, 2006

Last updated

Oct 31, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

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  NPD (past)
• Spaulding Professional Corporation

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  • NPI 1467492702
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1174571384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8085 WAYZATA BLVD STE 216",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261459",
            "telephone_number": "612-296-7942",
            "fax_number": "763-231-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 WILLOW ST",
            "address_2": "SUITE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032269",
            "telephone_number": "612-870-1242",
            "fax_number": "612-870-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMILAR",
        "first_name": "SCOTT",
        "middle_name": "MITCHEL",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP2868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "749250200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Savira Kambhu
• Alisha Kamboj
• Forum Kamdar, MD
• Priya Kamdar, D.D.S.
• Nevin Kamel
• Kellie Lynn Kamm, LMFT
• Sherrie L Kamm, PHD LP
• William Kamm, MD
• Kim Kammeier, CRNA
• Diane Ruth Kammer, R.N, MS

• Clinical Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.