Active NPI
Frank Scalise, PAC
- Medical Physician Assistant
- Denver, CO
National Provider Identifier
1790713402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0240
- Practice address
- 2100 Broadway
Stout Street Clinic
Denver, CO 80205-2526 - Phone
- (303) 293-2220
- Fax
- (303) 293-3977
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0240 | CO | Primary |
Addresses
Primary practice location
2100 Broadway
Stout Street Clinic
Denver, CO 80205-2526
Mailing address
2111 Champa St
Denver, CO 80205-2529
Phone (303) 293-2220
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0240 | CO | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332374400000",
"number": "1790713402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2111 CHAMPA ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802052529",
"telephone_number": "303-293-2220",
"fax_number": "303-293-3977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 BROADWAY",
"address_2": "STOUT STREET CLINIC",
"city": "DENVER",
"state": "CO",
"postal_code": "802052526",
"telephone_number": "303-293-2220",
"fax_number": "303-293-3977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCALISE",
"first_name": "FRANK",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2012-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CO",
"license": "0240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.