Individual provider Active NPI

Randi J. McLeod, M.D.

  • Emergency Medicine Physician
  • Lewisburg, PA
National Provider Identifier
1114972320
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD056652L Issued in PA
Practice address
1 Hospital Dr
Lewisburg, PA 17837-9350
Phone
(570) 522-2640
Fax
(570) 768-3921
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD056652L PA Primary

Addresses

Primary practice location

1 Hospital Dr
Lewisburg, PA 17837-9350

Mailing address

1 Hospital Dr Ste 306
Lewisburg, PA 17837-9350
Phone (570) 522-4110

Other identifiers 7

IdentifierTypeStateIssuer
855947OtherPAHIGHMARK BLUE SHIELD
15798530005MedicaidPA
232809429OtherTRICARE
321845OtherPAHEALTH AMERICA
02752156OtherNYNEW YORK MEDICAID
855947OtherPAKEYSTONE
930034292OtherPARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061012000520 PA Practitioner - Emergency Medicine 8628982568 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD056652LPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Aug 7, 2013 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Aug 7, 2013 Accepting new patients
Professional Emergency Care, PC Emergency Medicine Past Accepting new patients
Warrior Run Area Ambulance PastSince Apr 30, 2003 Accepting new patients

Locations

549 Fair St
Bloomsburg, PA 17815
Phone (570) 387-2100

100 N Academy Ave
Danville, PA 17822

3 Hospital Dr
Ste 206
Lewisburg, PA 17837
Phone (570) 522-9771

1 Hospital Dr
Ste 306
Lewisburg, PA 17837
Phone (570) 522-4110

1 Hospital Dr
Lewisburg, PA 17837
Phone (570) 522-2000

3 Hospital Dr
Ste 318
Lewisburg, PA 17837
Phone (570) 522-1007

Organizations & group practices 5

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1114972320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR STE 306",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379350",
            "telephone_number": "570-522-4110",
            "fax_number": "570-768-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379350",
            "telephone_number": "570-522-2640",
            "fax_number": "570-768-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "RANDI",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD056652L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "855947",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15798530005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "232809429",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "321845",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK MEDICAID",
            "identifier": "02752156",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "855947",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930034292",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, PA

Sources for this page

Verify at the official NPI Registry.