Individual provider Active NPI

Randall Lee Palmiscno, DMD

  • Dentist
  • Scottdale, PA
National Provider Identifier
1275752719
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
029547L Issued in PA
Practice address
111 Crossroads Rd
Scottdale, PA 15683-2417
Phone
(724) 887-3060
Fax
(724) 887-3945
NPI assigned
Apr 24, 2007
Last updated
Mar 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 029547L PA Primary

Addresses

Primary practice location

111 Crossroads Rd
Scottdale, PA 15683-2417

Mailing address

111 Crossroads Rd
Scottdale, PA 15683-2417
Phone (724) 887-3060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160328000207 PA Order and Referring Only - DentistPractitioner - Dentist 8820393291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029547LPAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Westmoreland Dental Appliances Inc Dentist Past Accepting new patients

Organizations & group practices 1

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1275752719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CROSSROADS RD",
            "city": "SCOTTDALE",
            "state": "PA",
            "postal_code": "156832417",
            "telephone_number": "724-887-3060",
            "fax_number": "724-887-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CROSSROADS RD",
            "city": "SCOTTDALE",
            "state": "PA",
            "postal_code": "156832417",
            "telephone_number": "724-887-3060",
            "fax_number": "724-887-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMISCNO",
        "first_name": "RANDALL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "029547L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottdale, PA

Sources for this page

Verify at the official NPI Registry.