Randall Lee Owen, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

23.003095 Issued in CT

Practice address

9 Washington Ave
Hamden, CT 06518-3267

Phone

(203) 865-6784

Fax

(203) 865-6788

NPI assigned

Jul 25, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, DC2 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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hartford Healthcare Urgent Care Centers LLCGroup PAC ID 7618242777, 201 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: randall.owen@xdr.hhchealthdirect.org

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.

• Hartford Healthcare Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Avon, CT
  • NPI 1093239683
  Medicare reassignment Care Compare group
• Hartford Healthcare Medical Group Specialists, PLLC

  • Surgery Physician
  • Hartford, CT
  • NPI 1023584216

  Surgical

  Medicare reassignment NPD
• Hartford Healthcare Medical Group, Inc

  • Surgery Physician
  • Wethersfield, CT
  • NPI 1043561301

  Physician Assistant

  Medicare reassignment NPD
• The Charlotte Hungerford Hospital

  • General Acute Care Hospital
  • Torrington, CT
  • NPI 1629075734
  Medicare reassignment
• Medical Faculty Associates, Inc

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1417990581
  Medicare reassignment
• Hartford Healthcare Medical Group Specialists LLC

  • Customized Equipment (DME)
  • Groton, CT
  • NPI 1295367068
  NPD
• The Charlotte Hungerford Hospital

  • Psychiatric Hospital Unit
  • Torrington, CT
  • NPI 1639255870
  NPD
• WRK Ventures, LLC

  • Urgent Care Clinic/Center
  • Southbury, CT
  • NPI 1194993980
  NPD (past)

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1437591971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MONTOYA DR",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064052533",
            "telephone_number": "475-434-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 WASHINGTON AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183267",
            "telephone_number": "203-865-6784",
            "fax_number": "203-865-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "RANDALL",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-25",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056252",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004314",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "23.003095",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "23.003095",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "23.003095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Raymond Ortman, DMD
• Karen Orzack-Moore, LCSW
• Robert B Ostroff, MD
• Our Village LLC
• Heidi Outtrim, LCSW
• Janice Owens-Lane, PH.D
• Madelyn Dawn Owens, LMSW
• McKenzie Sara Owens, ATC, EMT
• Tia Angelita Owens I
• Mildred Oxilas, DC

• Surgical Physician Assistant in Hamden, CT
• Providers in Hamden, CT by specialty
• Surgical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.