Individual provider Active NPI

Anne Randle, PA

  • Physician Assistant
  • Orchard Park, NY
National Provider Identifier
1295329894
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3670 S Benzing Rd
Orchard Park, NY 14127-1737
Phone
(716) 662-5357
NPI assigned
Feb 24, 2021
Last updated
May 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

3670 S Benzing Rd
Orchard Park, NY 14127-1737

Mailing address

12 Thomaston LN
Orchard Park, NY 14127-2526
Phone (716) 225-2302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210322001160 NY Practitioner - Physician Assistant 5698182541 Reassigns benefits to 3 organizations
I20260409001237 CA Practitioner - Physician Assistant 5698182541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Academic Medicine Services, Inc.Group PAC ID 0941105241, 115 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-5600

462 Grider St
Buffalo, NY 14215-3021

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brain & Spine Medical Services PLLC Single Specialty CurrentSince Mar 15, 2021 Accepting new patients
Mindful Living Center Ny LLC Single Specialty CurrentSince Oct 13, 2021 Accepting new patients
Hillcrest Ear Nose & Throat Inc Single Specialty Past Accepting new patients

Locations

3670 S Benzing Rd
Orchard Park, NY 14127
Phone (716) 662-5357

3670 S Benzing Rd
Ste A
Orchard Park, NY 14127
Phone (716) 662-5357

400 International Dr
Williamsville, NY 14221
Phone (716) 631-1516

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1295329894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 THOMASTON LN",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272526",
            "telephone_number": "716-225-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 S BENZING RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271737",
            "telephone_number": "716-662-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDLE",
        "first_name": "ANNE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-24",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.