NPIMap

Individual provider Active NPI

Randal Shelin, MD

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1447287719
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
8216 Issued in NV
Practice address
2020 Palomino LN
# 100
Las Vegas, NV 89106-4894
Phone
(702) 759-8600
Fax
(702) 384-1815
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 8216 NV Primary

Addresses

Primary practice location

2020 Palomino LN
# 100
Las Vegas, NV 89106-4894

Mailing address

2020 Palomino LN
# 100
Las Vegas, NV 89106-4894
Phone (702) 759-8600

Other identifiers 3

IdentifierTypeStateIssuer
1447287719MedicaidCA
200471120AMedicaidOK
201890003MedicaidNV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051012000667 NV Practitioner - Diagnostic Radiology 3274558820 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Tufts University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shelin Agrawal and Hyer PLLCGroup PAC ID 5890955959, 65 clinicians
Ellis Bandt Birkin Kollins and Wong PLLCGroup PAC ID 4486568946, 68 clinicians

Practice addresses (Care Compare)

Las Vegas, NV 89106
Phone (702) 759-8600

2020 Palomino LN
Suite 100
Las Vegas, NV 89106-4894
Phone (702) 759-8600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Bandt Birkin Kollins & Wong PLLC Diagnostic Radiology CurrentSince Oct 1, 2001 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Aug 14, 2019 Accepting new patients
Shelin Agrawal and Hyer PLLC Diagnostic Radiology CurrentSince Jan 22, 2012 Accepting new patients
Optum Medical Group Rhodes P C Current Accepting new patients
Pueblo Medical Imaging, LLC Diagnostic Radiology PastSince Dec 16, 1998 Accepting new patients
Medical Imaging Associates of Idaho Falls, Inc Diagnostic Radiology Past Accepting new patients
J Paul Wiesner & Associates Chartered Diagnostic Radiology PastSince Nov 3, 2019 Accepting new patients

Locations

801 E Williams Ave
Fallon, NV 89406
Phone (775) 423-0310

2811 W Horizon Ridge Pkwy
Henderson, NV 89052

2020 Palomino Ln
Ste 100
Las Vegas, NV 89106
Phone (702) 759-8779

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

Interoperability endpoints

  • Direct secure messaging: rshelin11553@direct.umcsn.com

Organizations & group practices 9

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 2

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1447287719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN",
            "address_2": "# 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN",
            "address_2": "# 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELIN",
        "first_name": "RANDAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "8216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447287719",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200471120A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201890003",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.