Individual provider Active NPI

Khiara Fay Scolari, PA

  • Physician Assistant
  • Valencia, CA
National Provider Identifier
1962979690
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA62119 Issued in CA
Practice address
23929 McBean Pkwy Ste 215
Valencia, CA 91355-4468
Phone
(661) 799-2542
NPI assigned
Oct 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022945 NY
Physician Assistant 363A00000X PA.0007797 CO
Physician Assistant 363A00000X PA62119 CA Primary

Addresses

Primary practice location

23929 McBean Pkwy Ste 215
Valencia, CA 91355-4468

Mailing address

35 Chestnut Hill Rd
Chelmsford, MA 01824-1935
Phone (978) 436-1018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 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
I20190325001969 NY Practitioner - Physician Assistant 9032459250 Reassigns benefits to 2 organizations
I20240927000234 CA Practitioner - Physician Assistant 9032459250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurosurgical Associates of Los Angeles, Inc.Group PAC ID 6608896535, 7 clinicians

Practice addresses (Care Compare)

23929 McBean Pkwy
Suite 215
Valencia, CA 91355-4468
Phone (661) 799-2542

25751 McBean Pkwy
Valencia, CA 91355-3701
Phone (661) 799-2542

Hospital & facility affiliations

  • Henry Mayo Newhall Hospital Hospital, Valencia, CA, CCN 050624
  • Northridge Hospital Medical Center Hospital, Northridge, CA, CCN 050116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62119CAMDDentist
PA62119CAMDPhysician Assistant
PA.0007797COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 6, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 6, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

1450 Madison Ave
#1
New York, NY 10029
Phone (212) 241-2763

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1010 N Broadway
Yonkers, NY 10701
Phone (914) 968-3535

Organizations & group practices 5

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": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1962979690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CHESTNUT HILL RD",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018241935",
            "telephone_number": "978-436-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23929 MCBEAN PKWY STE 215",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913554468",
            "telephone_number": "661-799-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOLARI",
        "first_name": "KHIARA",
        "middle_name": "FAY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022945",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007797",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.