Individual provider Active NPI

Randie Elise Lugenbeal, PA-C

  • Physician Assistant
  • Erie, PA
National Provider Identifier
1376207019
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA063085 Issued in PA
Practice address
100 Peach St Ste 300
Erie, PA 16507-1423
Phone
(814) 459-1851
NPI assigned
Oct 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA063085 PA Primary

Addresses

Primary practice location

100 Peach St Ste 300
Erie, PA 16507-1423

Mailing address

1414 W 11TH St Apt 1
Erie, PA 16502-2967
Phone (814) 860-0847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OH2 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
I20220330003130 PA Practitioner - Physician Assistant 9931595956 Reassigns benefits to 2 organizations
I20230712001338 OH Practitioner - Physician Assistant 9931595956

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OB-GYN Associates of Erie, PCGroup PAC ID 9133028616, 60 clinicians

Practice addresses (Care Compare)

100 Peach St
Erie, PA 16507-1423
Phone (814) 459-1851

2861 W 26TH St
Suite 1
Erie, PA 16506-3064
Phone (814) 480-7760

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Laboratory Associates of Erie LLC Current Accepting new patients
Francis H. Tseng MD Past Accepting new patients
Clinical Practice of Lecom Institute for Successful Living Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rlugenbeal274669@direct.ahn.org
  • Direct secure messaging: randie.lugenbeal.1@28732.direct.athenahealth.com
  • Direct secure messaging: rlugenbeal@lisl.medentdirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1376207019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W 11TH ST APT 1",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022967",
            "telephone_number": "814-860-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PEACH ST STE 300",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071423",
            "telephone_number": "814-459-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUGENBEAL",
        "first_name": "RANDIE",
        "middle_name": "ELISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.