Organization Active NPI

Ravi S Randhawa DO PA

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Delray Beach, FL
National Provider Identifier
1275720179
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
OS0007402 Issued in FL
Legal business name
RAVI S RANDHAWA DO PA
Practice address
16244 S Military TRL
Suite 710
Delray Beach, FL 33484-6534
Phone
(561) 638-8505
Fax
(561) 638-8504
NPI assigned
Sep 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Authorized official

Name
Ms. Peg Sadowski
Title
Manager
Phone
(561) 638-8505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YX0007X OS0007402 FL Primary

Addresses

Primary practice location

16244 S Military TRL
Suite 710
Delray Beach, FL 33484-6534

Mailing address

16244 S Military TRL
Suite 710
Delray Beach, FL 33484-6534
Phone (561) 638-8505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080411000103 FL Part B Supplier - Clinic/Group Practice 9234216441 Receives reassigned benefits from 1 practitioner
Practice locations: Boca Raton, FL; Delray Beach, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1275720179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16244 S MILITARY TRL",
            "address_2": "SUITE 710",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846534",
            "telephone_number": "561-638-8505",
            "fax_number": "561-638-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16244 S MILITARY TRL",
            "address_2": "SUITE 710",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846534",
            "telephone_number": "561-638-8505",
            "fax_number": "561-638-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVI S RANDHAWA DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "SADOWSKI",
        "authorized_official_first_name": "PEG",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-638-8505",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "FL",
            "license": "OS0007402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.