Organization Active NPI

Randy R. Shemer D.O. L.L.C.

  • Internal Medicine Physician
  • Monaca, PA
National Provider Identifier
1336273218
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS-008808L Issued in PA
Legal business name
RANDY R. SHEMER D.O. L.L.C.
Practice address
3419 Brodhead Rd
Monaca, PA 15061-3131
Phone
(724) 770-0771
Fax
(724) 770-0607
NPI assigned
Mar 15, 2007
Last updated
May 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2011

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

Authorized official

Name
Dr. Randy Robert Shemer, D.O.NPI 1376567610
Title
Owner
Phone
(727) 770-0771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS-008808L PA Primary

Addresses

Primary practice location

3419 Brodhead Rd
Monaca, PA 15061-3131

Mailing address

3419 Brodhead Rd
Monaca, PA 15061-3131
Phone (724) 770-0771

Other identifiers 1

IdentifierTypeStateIssuer
0015442300007MedicaidPA

Other names 1

  • Randy R. Shemer D.O. L.L.C. Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080716000056 PA Part B Supplier - Clinic/Group Practice 0840363495 Receives reassigned benefits from 4 practitioners
Practice locations: Aliquippa, PA

National Provider Directory

National Provider Directory

Locations

2424 Mill St
Aliquippa, PA 15001
Phone (724) 770-0771

3419 Brodhead Rd
Monaca, PA 15061
Phone (724) 770-0771

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306454400000",
    "number": "1336273218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 BRODHEAD RD",
            "city": "MONACA",
            "state": "PA",
            "postal_code": "150613131",
            "telephone_number": "724-770-0771",
            "fax_number": "724-770-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 BRODHEAD RD",
            "city": "MONACA",
            "state": "PA",
            "postal_code": "150613131",
            "telephone_number": "724-770-0771",
            "fax_number": "724-770-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDY R. SHEMER D.O. L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2011-05-27",
        "status": "A",
        "authorized_official_last_name": "SHEMER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-770-0771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS-008808L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015442300007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Randy R. Shemer D.O. L.L.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Monaca, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; 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.