Individual provider Active NPI

Elizabeth Randall, PSYD, LMHC

  • Psychologist
  • Buffalo, NY
National Provider Identifier
1235633447
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
023579 Issued in NY
Practice address
800 Hertel Ave Ste 101
Buffalo, NY 14207-1906
Phone
(171) 656-6505
NPI assigned
Mar 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 023579 NY Primary
Mental Health Counselor 101YM0800X 007768 NY

Addresses

Primary practice location

800 Hertel Ave Ste 101
Buffalo, NY 14207-1906

Mailing address

800 Hertel Ave Ste 101
Buffalo, NY 14207-1906
Phone (171) 656-6505

Other practice location 1

800 Hertel Ave Ste 101
Buffalo, NY 14207-1906
Phone (716) 566-5050

Other identifiers 1

IdentifierTypeStateIssuer
01465451MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Allscripts Health Information Exchange (HIE)

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220224002129 NY Practitioner - Clinical Psychologist 2668866278 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
People IncGroup PAC ID 3375457765, 15 clinicians

Practice addresses (Care Compare)

800 Hertel Ave
Suite 101
Buffalo, NY 14207-1906
Phone (716) 566-5050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007768NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Presence Sealy Counseling and Development Licensedclinicalservicespllc CurrentSince May 1, 2024 Accepting new patients
People Inc CurrentSince Nov 17, 2021 Accepting new patients
People Inc. CurrentSince Jul 21, 2024 Accepting new patients
Presence Psychology, LMSW, PT, OT and SLP Services, PLLC CurrentSince May 1, 2024 Accepting new patients
People Inc CurrentSince Nov 17, 2021 Accepting new patients
Medical Practitioner Services of Wny PC CurrentSince Nov 27, 2021 Accepting new patients

Locations

800 Hertel Ave
Ste 101
Buffalo, NY 14207
Phone (716) 566-5007

800 Hertel Ave
#101
Buffalo, NY 14207
Phone (716) 566-5007

800 Hertel Ave
Ste 104
Buffalo, NY 14207

115 Fall St
Seneca Falls, NY 13148
Phone (315) 515-5183

1219 N Forest Rd
Williamsville, NY 14221
Phone (716) 634-8152

Interoperability endpoints

  • Direct secure messaging: elizabethrandall@peopleinc.medentdirect.com

Organizations & group practices 6

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": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1235633447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 HERTEL AVE STE 101",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071906",
            "telephone_number": "171-656-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HERTEL AVE STE 101",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071906",
            "telephone_number": "171-656-6505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Hertel Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142071906",
            "country_code": "US",
            "telephone_number": "716-566-5050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "ELIZABETH",
        "credential": "PSYD, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "023579",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "007768",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01465451",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Allscripts",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Hertel Ave Ste 101",
            "city": "Buffalo",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142071906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.