Individual provider Active NPI

Scott William Barry, PA-C

  • Surgical Physician Assistant
  • Denver, CO
National Provider Identifier
1710947874
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
777 Bannock St # Mc3240
Denver, CO 80204-4597
Phone
(303) 436-6000
NPI assigned
Mar 24, 2006
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAC0206 ND
Physician Assistant 363A00000X 97 MT
Surgical Physician Assistant 363AS0400X 3112-23 WI
Surgical Physician Assistant 363AS0400X PA2020-0012 NM
Surgical Physician Assistant 363AS0400X AZ
Surgical Physician Assistant 363AS0400X C08711 MD
Surgical Physician Assistant 363AS0400X CO Primary

Addresses

Primary practice location

777 Bannock St # Mc3240
Denver, CO 80204-4597

Mailing address

6036 N 19TH Ave Ste 505
Phoenix, AZ 85015-2143
Phone (022) 490-8396

Other practice location 1

2635 N 7th St
Grand Jct, CO 81501-8209
Phone (970) 298-3188

Other practice location 2

6036 N 19th Ave Ste 505
Phoenix, AZ 85015-2143
Phone (602) 249-0839

Other practice location 3

100 E Carroll St
Salisbury, MD 21801-5422
Phone (410) 546-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160218002281 CO Practitioner - Physician Assistant 5294991964 Reassigns benefits to 2 organizations
I20201020001444 AZ Practitioner - Physician Assistant 5294991964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51511CAMDOncology Pharmacist
2397NEMDSpeech-Language Pathologist
97MTMDPhysician Assistant
C08711MDMDSurgical Physician Assistant
PA2020-0012NMMDSurgical Physician Assistant
3112-23WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Jul 15, 2023 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 9, 2024 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jul 15, 2023 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 9, 2024 Accepting new patients
VHS Outpatient Clinics, Inc. CurrentSince Oct 15, 2020 Accepting new patients
Paracelsus Healthcare Corp Past Accepting new patients
St Mary's Hospital and Medical Center, Inc Past Accepting new patients

Locations

13677 W McDowell Rd
Goodyear, AZ 85395
Phone (623) 536-4200

5130 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (602) 237-0039

6036 N 19th Ave
Ste 505
Phoenix, AZ 85015
Phone (602) 249-0839

777 Bannock St
Denver, CO 80204

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

750 Wellington Ave
Ste 3A
Grand Junction, CO 81501
Phone (970) 248-3188

7624 Warren Pkwy
Frisco, TX 75034
Phone (469) 803-3000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1710947874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6036 N 19TH AVE STE 505",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152143",
            "telephone_number": "022-490-8396",
            "fax_number": "602-249-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST # MC3240",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-436-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2635 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Grand Jct",
            "state": "CO",
            "postal_code": "815018209",
            "country_code": "US",
            "telephone_number": "970-298-3188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6036 N 19th Ave Ste 505",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850152143",
            "country_code": "US",
            "telephone_number": "602-249-0839",
            "fax_number": "602-249-0979",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 E Carroll St",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218015422",
            "country_code": "US",
            "telephone_number": "410-546-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRY",
        "first_name": "SCOTT",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "97",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "3112-23",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NM",
            "license": "PA2020-0012",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C08711",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.