NPIMap

Individual provider Active NPI

Dana Marie Randall, PA-C

  • Surgical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1013211630
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA055363 Issued in PA
Practice address
235 S 8TH St
1St Floor
Philadelphia, PA 19106-3519
Phone
(215) 829-3493
NPI assigned
Dec 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA055363 PA Primary

Addresses

Primary practice location

235 S 8TH St
1St Floor
Philadelphia, PA 19106-3519

Mailing address

235 S 8TH St
1St Floor
Philadelphia, PA 19106-3519
Phone (215) 829-3493

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191206000585 CA Practitioner - Physician Assistant 6507048501 Reassigns benefits to 2 organizations
I20191206001174 NV Practitioner - Physician Assistant 6507048501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barton Medical FoundationGroup PAC ID 5395127682, 97 clinicians

Practice addresses (Care Compare)

155 Hwy 50
Stateline, NV 89449-9816
Phone (775) 589-8900

165 Hwy 50
Stateline, NV 89449-9816
Phone (775) 589-8950

2074 Lake Tahoe Blvd
Suite 4
South Lake Tahoe, CA 96150-6408
Phone (530) 543-5554

2170 B S Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 539-6620

2170 S Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 543-5807

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
89.85
Promoting interoperability
94.05
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.42 of 100Reported as group
Quality
93.48
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
89.85
Promoting interoperability
94.05
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Tahoe Orthopaedic Institute a Watson-Swanson Professional Corp CurrentSince Oct 11, 2019 Accepting new patients

Locations

1139 3rd St
South Lake Tahoe, CA 96150
Phone (530) 541-3100

935 Mica Dr
Ste 13
Carson City, NV 89705
Phone (775) 783-3065

Interoperability endpoints

  • Direct secure messaging: drandall147893@direct.renown.org

Organizations & group practices 4

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 6

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": "1293062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1013211630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 S 8TH ST",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063519",
            "telephone_number": "215-829-3493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 S 8TH ST",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063519",
            "telephone_number": "215-829-3493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "DANA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-23",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA055363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.