CHAD RANDAL VICKERS (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1780753681

CHAD RANDAL VICKERS (PMHNP) is a healthcare provider. based in Saint paul, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. 706002 (TX). The NPI Number for CHAD RANDAL VICKERS (PMHNP) is 1780753681

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
CHAD RANDAL VICKERS (PMHNP)
NPI
1780753681
Phone
(651) 489-7740
Address
135 COLORADO STREET EAST
Enumeration Date
6 November 2006
Last Update Date
22 April 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2144328322
Graduation Year
2011 (15 years ago)
PAC ID
2567555311
Group Practice PAC ID
5991176356
Professional Enrollment ID
I20070910000698
Address ID
TX760635842MA240XXRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience85
Completeness75
Years active:19State licenses:3Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

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Provider Addresses for CHAD RANDAL VICKERS (PMHNP)

  • 135, East Colorado Street, West Side, Saint Paul, Ramsey County, Minnesota, 55107, United States

    SAINT PAUL, MN 55107

    Phone: (651) 489-7740

    Fax: (651) 489-6458

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-02-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070910000698INurse PractitionerTXTBD
I20190122000290INurse PractitionerDETBD
I20190220000002INurse PractitionerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes12053$0
99213Established patient office or other outpatient visit, 20-29 minutes2015$0
View full utilization report →

Insurance plans in this area (ZIP 55107)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991176356View full group profile
NameSpecialtyState
Clinical Social WorkerLA
Clinical Social WorkerCT
Clinical Social WorkerMS
Nurse PractitionerRI
Clinical Social WorkerGA
Clinical Social WorkerTX
Nurse PractitionerTX
Clinical Social WorkerLA
Mental Health CounselorTX
P S Y C H I A T R YTX

Reviews

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Frequently asked questions

What unique ID ties claims to CHAD RANDAL VICKERS (PMHNP)?
NPI 1780753681 is assigned to CHAD RANDAL VICKERS (PMHNP) under the national enumeration system.
Is CHAD RANDAL VICKERS (PMHNP) active in the national directory?
CHAD RANDAL VICKERS (PMHNP)'s public NPI profile is in an active state.
Does CHAD RANDAL VICKERS (PMHNP) list a primary specialty?
If you are matching referrals, note Psychiatric/Mental Health Nurse Practitioner for CHAD RANDAL VICKERS (PMHNP). Clinical services aligned with this taxonomy classification.
Where is CHAD RANDAL VICKERS (PMHNP)'s primary listing?
We display Saint Paul, Minnesota because that is what the record indicates for CHAD RANDAL VICKERS (PMHNP).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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