Individual provider Active NPI

Randi Lynn Sjogren, M.D.

  • Pediatrics Physician
  • White Plains, NY
National Provider Identifier
1184677718
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
236832-1 Issued in NY
Practice address
410 N Broadway
White Plains, NY 10603-3312
Phone
(914) 948-0353
NPI assigned
May 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 236832-1 NY Primary

Addresses

Primary practice location

410 N Broadway
White Plains, NY 10603-3312

Mailing address

410 N Broadway
White Plains, NY 10603-3312
Phone (914) 948-0353

Other identifiers 1

IdentifierTypeStateIssuer
02713862MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060519000130 NY Practitioner - Pediatric Medicine 0345297941 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
236832-1NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Health Medical, P.C. Pediatrics CurrentSince Mar 1, 2017 Accepting new patients
Westchester Health Medical, P.C. CurrentSince Mar 1, 2017 Accepting new patients
Valley Pediatrics PC Pediatrics Past Accepting new patients

Locations

60 Goldens Bridge Rd
Katonah, NY 10536
Phone (914) 232-1919

91 Smith Ave
Mount Kisco, NY 10549
Phone (914) 241-1717

410 N Broadway
White Plains, NY 10603
Phone (914) 948-0353

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: rsjogren67906@northwell.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184677718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N BROADWAY",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106033312",
            "telephone_number": "914-948-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N BROADWAY",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106033312",
            "telephone_number": "914-948-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SJOGREN",
        "first_name": "RANDI",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "236832-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02713862",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.