Randall Scott Anselmo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

042-0010651 Issued in VT

Practice address

130 Health Park Blvd
St Augustine, FL 32086-5776

Phone

(904) 826-3469

Fax

(904) 808-4608

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT, FL2 enrollments

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 2

Specialty

Family Practice

Education

University of Florida College of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Flagler Family Medicine P aGroup PAC ID 9335114347, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brooks Rehabilitation Home Health Home health agency, Jacksonville, FL, CCN 103174
• Bravery Home Healthcare Home health agency, St Augustine, FL, CCN 687344
• Flagler Home Care LLC Home health agency, Saint Augustine, FL, CCN 108211
• Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090
• AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ADBCAA
• FHIR API: https://fhir4.healow.com/fhir/r4/ADBCAA/Endpoint/ADBCAA

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.

• Flagler Family Medicine P a

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1215080809
  Medicare reassignment Care Compare group NPD
• Southwestern Vermont Medical Center Inc.

  • Internal Medicine Physician
  • Bennington, VT
  • NPI 1184994162

  Family Medicine

  Medicare reassignment NPD
• Flagler Family Medicine PA

  • Foot & Ankle Surgery Podiatrist
  • St Augustine, FL
  • NPI 1821406679

  Family Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bravery NE FL LLC

  • Home Health Agency
  • Saint Augustine, FL
  • NPI 1619742657
  Care Compare affiliation
• Brooks Home Care Advantage, Inc.

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1184895740
  Care Compare affiliation
• Flagler Home Care, LLC

  • Home Health Agency
  • Saint Augustine, FL
  • NPI 1649791823
  Care Compare affiliation
• Flagler Hospital Inc

  • General Acute Care Hospital
  • St Augustine, FL
  • NPI 1144211020
  Care Compare affiliation
• Flagler Hospital, Inc.

  • Urgent Care Clinic/Center
  • Saint Augustine, FL
  • NPI 1447527965

  Hospital

  Care Compare affiliation
• Memorial Hospital Flagler Inc

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1679678486
  Care Compare affiliation

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1417024936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 MARSH POINT CIR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320805865",
            "telephone_number": "802-375-4005",
            "fax_number": "802-491-8231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865776",
            "telephone_number": "904-826-3469",
            "fax_number": "904-808-4608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 College Dr",
            "address_purpose": "LOCATION",
            "city": "Bennington",
            "state": "VT",
            "postal_code": "052016003",
            "country_code": "US",
            "telephone_number": "802-440-4426",
            "fax_number": "802-440-4427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANSELMO",
        "first_name": "RANDALL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "042-0010651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Andrews, RBT
• Jennifer V Angel, APRN
• Lisa Ann Angel, LMFT
• Anovus, Inc
• Ansaarie Cardiac & Endovascular Center of Excellence
• Cheryl G Anthony, LMHC
• Monica Antigua
• Srilatha Anumasu, RPH
• Aol Counseling, Coaching and Consulting Services
• Aplus Children'S Therapy

• Family Medicine Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.