Individual provider Active NPI

Deborah Lyn Randaisi, R.P.A

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1073545166
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009073-1 Issued in NY
Practice address
1375 Washington Ave
Suite 101
Albany, NY 12206-1056
Phone
(518) 438-4483
Fax
(518) 482-4201
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 009073-1 NY Primary

Addresses

Primary practice location

1375 Washington Ave
Suite 101
Albany, NY 12206-1056

Mailing address

1375 Washington Ave
Suite 101
Albany, NY 12206-1056
Phone (518) 438-4483

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110210000103 NY Practitioner - Physician Assistant 6507046414 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Practice addresses (Care Compare)

1 Atwell Rd
Cooperstown, NY 13326-1394

178 Grandview Dr
Cobleskill, NY 12043-5144
Phone (518) 254-3456

Hospital & facility affiliations

  • Bassett Healthcare Hospital, Cooperstown, NY, CCN 330136
  • Cobleskill Regional Hospital Hospital, Cobleskill, NY, CCN 331320
  • Aurelia Osborn Fox Memorial Hospital Hospital, Oneonta, NY, CCN 330085

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009073NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Aug 15, 2017 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Aug 15, 2017 Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

460 Andes Rd
Delhi, NY 13753
Phone (607) 746-0300

140 Burwell St
Little Falls, NY 13365
Phone (315) 823-1000

130 North St
Walton, NY 13856
Phone (607) 865-6541

Interoperability endpoints

  • Direct secure messaging: drandaisi317157@bassett.direct-ci.net

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 4

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1073545166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 WASHINGTON AVE",
            "address_2": "SUITE 101",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061056",
            "telephone_number": "518-438-4483",
            "fax_number": "518-482-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 WASHINGTON AVE",
            "address_2": "SUITE 101",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061056",
            "telephone_number": "518-438-4483",
            "fax_number": "518-482-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDAISI",
        "first_name": "DEBORAH",
        "middle_name": "LYN",
        "credential": "R.P.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009073-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.