Nicole RG Randall, LCSW CADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC17326 Issued in ME

Practice address

322 Main St
Bar Harbor, ME 04609-1648

Phone

(207) 288-8604

NPI assigned

Sep 19, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mount Desert Island HospitalGroup PAC ID 0941250963, 61 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Desert Island Hospital Hospital, Bar Harbor, ME, CCN 201304

Merit-based Incentive Payment System (MIPS)

Final score

96.58 of 100Reported as apm

Quality

83.17

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/b5eba017-85d4-4b6c-a2f0-9b2c7b0c38dd/

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.

• Mount Desert Island Hospital

  • Critical Access Hospital
  • Bar Harbor, ME
  • NPI 1790764512
  Medicare reassignment Care Compare group NPD
• Mount Desert Island Hospital

  • Dental Clinic/Center
  • Southwest Harbor, ME
  • NPI 1235553413
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mount Desert Island Hospital

  • Dental Clinic/Center
  • Southwest Harbor, ME
  • NPI 1235553413

  Hospital

  Care Compare affiliation
• Mount Desert Island Hospital

  • Critical Access Hospital
  • Bar Harbor, ME
  • NPI 1790764512
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1023592771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 MAIN ST FL 3",
            "city": "BAR HARBOR",
            "state": "ME",
            "postal_code": "046091648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 MAIN ST",
            "city": "BAR HARBOR",
            "state": "ME",
            "postal_code": "046091648",
            "telephone_number": "207-288-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "NICOLE",
        "middle_name": "RG",
        "credential": "LCSW CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "CAC6664",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC17326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Michael Perme, MD
• Suzanne Louise Picurro, PT
• Gabriel Johnson Plourde, MD
• Christopher W Price, CRNA
• Jennifer Elizabeth Racicot, LMT
• Caitlin C Ratten
• Kathryn Ray, RN
• Mathilde Ac Reznik, D.M.D.
• Oleg I Reznik, MD
• Rite Aid of Maine Inc

• Clinical Social Worker in Bar Harbor, ME
• Providers in Bar Harbor, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.

Verify at the official NPI Registry.