Active NPI
Randi Clarke, NP
- Adult Health Nurse Practitioner
- Woodbury, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- F3052261
- Practice address
- 43 Crossways Park Dr W
Woodbury, NY 11797-2002 - Phone
- (516) 938-3000
- NPI assigned
- Sep 14, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | F3052261 | NY | Primary |
Addresses
Primary practice location
43 Crossways Park Dr W
Woodbury, NY 11797-2002
Mailing address
43 Crossways Park Dr W
Woodbury, NY 11797-2002
Phone (516) 938-3000
Other practice location 1
300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 410-4497
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 E 77TH St
New York, NY 10075-1850
Phone (212) 434-6500
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F3052261 | NY | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Cardiovascular Disease | Current | Accepting new patients |
Locations
39 Brentwood Rd
Ste 101
Bay Shore, NY 11706
Phone (631) 590-7400
402 Potter Blvd
Brightwaters, NY 11718
Phone (631) 689-1400
330 S Service Rd
Ste 121
Melville, NY 11747
Phone (516) 876-4100
100 E 77th St
#2
New York, NY 10075
Phone (212) 434-2460
300 Community Dr
Plandome, NY 11030
43 Crossways Park Dr W
Woodbury, NY 11797
Phone (516) 938-3000
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
Interoperability endpoints
- randiclarke@nslijmedgr.allscriptsdirect.net
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647561600000",
"number": "1003149618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 CROSSWAYS PARK DR W",
"city": "WOODBURY",
"state": "NY",
"postal_code": "117972002",
"telephone_number": "516-938-3000",
"fax_number": "516-938-3239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 CROSSWAYS PARK DR W",
"city": "WOODBURY",
"state": "NY",
"postal_code": "117972002",
"telephone_number": "516-938-3000"
}
],
"practiceLocations": [
{
"address_1": "300 Community Dr",
"address_purpose": "LOCATION",
"city": "Manhasset",
"state": "NY",
"postal_code": "110303816",
"country_code": "US",
"telephone_number": "516-410-4497",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLARKE",
"first_name": "RANDI",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-14",
"last_updated": "2022-03-18",
"certification_date": "2022-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "F3052261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Woodbury, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.