Active NPI
Randy Levine, PH.D.
- Clinical Psychologist
- Hollywood, FL
National Provider Identifier
1306862297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY003923
- Practice address
- 2450 Hollywood Blvd Ste 303a
Hollywood, FL 33020-6624 - Phone
- (954) 965-9228
- NPI assigned
- Jul 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY003923 | FL | Primary |
Addresses
Primary practice location
2450 Hollywood Blvd Ste 303a
Hollywood, FL 33020-6624
Mailing address
7360 NW 17TH CT
Pembroke Pines, FL 33024-1000
Phone (954) 965-9228
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070120000001 | FL | Practitioner - Clinical Psychologist | 1355342288 | Practice locations: Hollywood, FL; Plantation, FL |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
150 S University Dr
Suite a
Plantation, FL 33324-3327
Phone (954) 965-9228
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY003923 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632182400000",
"number": "1306862297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7360 NW 17TH CT",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330241000",
"telephone_number": "954-965-9228",
"fax_number": "954-966-2208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 HOLLYWOOD BLVD STE 303A",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330206624",
"telephone_number": "954-965-9228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVINE",
"first_name": "RANDY",
"name_prefix": "Mr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2021-09-21",
"certification_date": "2021-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY003923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.