Randall Patkin, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

70754 Issued in MA

Practice address

400 Highland Ave
Suite 20
Salem, MA 01970-7003

Phone

(978) 744-1177

Fax

(978) 910-0125

NPI assigned

Jun 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Perelman School of Med at the University of Pennsylvania, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Center of the North Shore, LLCGroup PAC ID 2264561174, 7 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: patkin.randall.ecpc@direct.partners.masshiway.net

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.

• Eye Center of the North Shore, LLC

  • Ophthalmology Physician
  • Salem, MA
  • NPI 1053562330
  Medicare reassignment Care Compare group NPD Authorized official
• Eye Center of the North Shore, LLC

  • Eyewear Supplier
  • Salem, MA
  • NPI 1609177948
  NPD Authorized official

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1366447864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HIGHLAND AVE",
            "address_2": "SUITE 20",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019707003",
            "telephone_number": "978-744-1177",
            "fax_number": "978-910-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HIGHLAND AVE",
            "address_2": "SUITE 20",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019707003",
            "telephone_number": "978-744-1177",
            "fax_number": "978-910-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATKIN",
        "first_name": "RANDALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "70754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3047288",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel Pastel
• Elvis Nikhilkumar Patel, M.D.
• Hiren Patel, M,D.
• Kishan G Patel, MD
• Justin Pathickal, D.O.
• Casey Paton, MD
• Patrick M. Szafran, Inc.
• John Patti, MD
• Kate Paulhus, DPT
• Eleanor R Paulino, LMT

• Ophthalmology Physician in Salem, MA
• Providers in Salem, MA by specialty
• Ophthalmology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.

Verify at the official NPI Registry.