Kristin Randa, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

72836 Issued in WI

Practice address

2780 Cleveland Ave Ste 709
Fort Myers, FL 33901-5857

Phone

(239) 343-3831

Fax

(239) 343-2301

NPI assigned

Mar 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Family Practice

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aurora Memorial Hospital Burlington Hospital, Burlington, WI, CCN 520059

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kranda267412@direct.leememorial.org
• Direct secure messaging: kranda188937@direct.myadvocateaurora.org
• Direct secure messaging: kristin.randa.1@29613.direct.athenahealth.com

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.

• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Aurora Advanced Healthcare, Inc.

  • Family Medicine Physician
  • Milwaukee, WI
  • NPI 1265629133
  Medicare reassignment NPD
• Lakeshore Medical Clinic, LLC

  • Family Medicine Physician
  • St Francis, WI
  • NPI 1003861188
  Medicare reassignment NPD
• Aurora Advanced Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Summit, WI
  • NPI 1477186633
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Lakeshore Medical Clinic LTD

  dba LMC Bucyrus Medical

  • Family Medicine Physician
  • South Milwaukee, WI
  • NPI 1174851893
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1801941075
  NPD (past)

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

• Aurora Health Care Southern Lakes, Inc.

  dba Aurora Medical Center Burlington

  • General Acute Care Hospital
  • Burlington, WI
  • NPI 1861557753
  Care Compare affiliation

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654387200000",
    "number": "1417452996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11211 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271035",
            "telephone_number": "414-454-8300",
            "fax_number": "239-343-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 CLEVELAND AVE STE 709",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339015857",
            "telephone_number": "239-343-3831",
            "fax_number": "239-343-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDA",
        "first_name": "KRISTIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2022-06-05",
        "certification_date": "2022-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS17784",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "72836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110556500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn L Ramtahal, MSED
• Aakash Rana
• Rupam Rana, DDS
• Van G Rana, 09221980
• Amanda Ranalli
• Allison J Randall, PHARM.D
• Jennifer Randall, PMHNP
• Kaelyn Randall
• Marcum Ralph Randall, LP, LPT
• Veronica Rando

• Family Medicine Physician in Fort Myers, FL
• Providers in Fort Myers, 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 Jun 5, 2022; 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.