Individual provider Active NPI

Randall F Sclar, PA

  • Physician Assistant
  • Evergreen, CO
National Provider Identifier
1255406468
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
00731 Issued in CO
Practice address
28000 Meadow Dr #210
Evergreen, CO 80439
Phone
(303) 679-8500
Fax
(303) 679-8505
NPI assigned
Nov 22, 2006
Last updated
Jan 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 00731 CO Primary

Addresses

Primary practice location

28000 Meadow Dr #210
Evergreen, CO 80439

Mailing address

28000 Meadow Dr #210
Arapahoe Peak Health Center
Evergreen, CO 80439
Phone (303) 679-8500

Other identifiers 2

IdentifierTypeStateIssuer
C525318OtherCOPTAN
C544638OtherCOEMPLOYER PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20240328002572 CO Practitioner - Physician Assistant 0446209571 Reassigns benefits to 1 organization

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
Conifer Medical Center, PCGroup PAC ID 4789676131, 16 clinicians

Practice addresses (Care Compare)

26659 Pleasant Park Rd
Conifer, CO 80433-7768
Phone (303) 647-5300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
731COMDMental Health Counselor
00731COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Big Sky Medicine PC Past Accepting new patients
Conifer Medical Center, PC Past Accepting new patients

Organizations & group practices 3

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1255406468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28000 MEADOW DR #210",
            "address_2": "ARAPAHOE PEAK HEALTH CENTER",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "80439",
            "telephone_number": "303-679-8500",
            "fax_number": "303-679-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28000 MEADOW DR #210",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "80439",
            "telephone_number": "303-679-8500",
            "fax_number": "303-679-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCLAR",
        "first_name": "RANDALL",
        "middle_name": "F",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "00731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "C525318",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER PTAN",
            "identifier": "C544638",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen, CO

Sources for this page

Verify at the official NPI Registry.