Randy Marlon Pellew, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

339366 Issued in NY

Practice address

27005 76TH Ave
New Hyde Park, NY 11040-1402

Phone

(718) 470-7310

NPI assigned

Feb 28, 2015

Last updated

Jun 22, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment Care Compare group NPD
• Bronx Medical Practice P.C.

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1356726087
  Medicare reassignment NPD
• Essen Medical Associates, PC

  • Legal Medicine
  • Bronx, NY
  • NPI 1366418709
  Medicare reassignment NPD
• House Call Medical Services of New York, PLLC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1851345946
  Medicare reassignment NPD
• Essen Medical Associates, PC

  • Podiatrist
  • Bronx, NY
  • NPI 1720799158
  NPD
• North Shore - Lij Medical PC

  dba NSLIJ Medical In Queens

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

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

{
    "created_epoch": "1425081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1447642400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-470-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-470-7310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12066 131st St",
            "address_purpose": "LOCATION",
            "city": "South Ozone Park",
            "state": "NY",
            "postal_code": "114202922",
            "country_code": "US",
            "telephone_number": "718-810-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELLEW",
        "first_name": "RANDY",
        "middle_name": "MARLON",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-28",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Marie Pearlman, P.T.
• Sun F Pei, DO
• Brian Pekkerman, D.O
• Jessica Lisa Pellegrini, AU.D., CCC-A, F-AAA
• Nicholas Pellegrino
• Kelly Marie Pellicane, NP
• Lindsay Pellicano, NP
• Pelvic Floor Wellness LLC
• Allison Pennisi, SLP
• Attilio S. Pensavalle, PT DPT

• Family Nurse Practitioner in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.