RANDALL SCOTT BRANDT (PAC) – Physician Assistant, NPI 1710978754

RANDALL SCOTT BRANDT (PAC) is a healthcare provider. based in Mauston, Wisconsin. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PAC. They hold a License No. 844 (WI). The NPI Number for RANDALL SCOTT BRANDT (PAC) is 1710978754

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
RANDALL SCOTT BRANDT (PAC)
NPI
1710978754
Phone
Not provided
Address
1040 DIVISION ST
Enumeration Date
31 October 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1995 (31 years ago)
PAC ID
0840299350
Group Practice PAC ID
8527971399
Professional Enrollment ID
I20061211000548
Address ID
WI539481931MA1050XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,678 PHYSICIAN ASSISTANT in WI

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Provider Addresses for RANDALL SCOTT BRANDT (PAC)

  • 1040, Division Street, Mauston, Juneau County, Wisconsin, 53948, United States

    MAUSTON, WI 539481931

    Phone:

    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: 2006-12-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20061211000548IPhysician AssistantWITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 53948)

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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: 8527971399View full group profile
NameSpecialtyState
-WI
Physician AssistantWI
Certified Registered Nurse Anesthetist (Crna)WI
Orthopedic SurgeryWI
O B S T E T R I C S/ G Y N E C O L O G YWI
Nurse PractitionerWI
General SurgeryWI
-WI
Orthopedic SurgeryWI
Physician AssistantWI

Reviews

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Frequently asked questions

What federal number belongs to RANDALL SCOTT BRANDT (PAC)?
The federal identifier for RANDALL SCOTT BRANDT (PAC) is NPI 1710978754.
Is RANDALL SCOTT BRANDT (PAC) active in the national directory?
RANDALL SCOTT BRANDT (PAC)'s public NPI profile is in an active state.
What kind of provider is RANDALL SCOTT BRANDT (PAC)?
The page reflects Physician Assistant for RANDALL SCOTT BRANDT (PAC). Clinical services aligned with this taxonomy classification.
Where is RANDALL SCOTT BRANDT (PAC)'s primary listing?
We display Mauston, Wisconsin because that is what the record indicates for RANDALL SCOTT BRANDT (PAC).
Is RANDALL SCOTT BRANDT (PAC) a real provider?
This page reflects official NPPES data for NPI 1710978754. Always confirm identity and privileges with the practice and licensing boards.

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