Susan M Randall-Mantella, RNNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F330714 Issued in NY

Practice address

4117 Medical Center Dr
Pod C
Fayetteville, NY 13066-6600

Phone

(315) 329-4975

Fax

(315) 329-4970

NPI assigned

Apr 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: s.randall-mantella@flhmedical.medentdirect.com

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.

• FLH Medical, PC

  • Family Medicine Physician
  • Penn Yan, NY
  • NPI 1215174644
  Medicare reassignment NPD
• Geneva General Hospital, Inc.

  dba Geneva General Hospital Physician Practices

  • Family Medicine Physician
  • Geneva, NY
  • NPI 1215194501
  Medicare reassignment NPD
• Soldiers & Sailors Memorial Hospital

  • Critical Access Hospital
  • Penn Yan, NY
  • NPI 1215044516
  Medicare reassignment NPD
• Joseph Anthony Lorenzetti, M.D.

  • Family Medicine Physician
  • Seneca Falls, NY
  • NPI 1336174457
  Medicare reassignment
• FLH Medical, PC

  • Gastroenterology Physician
  • Geneva, NY
  • NPI 1164766325
  NPD
• Geneva General Hospital, Inc

  • Family Medicine Physician
  • Clyde, NY
  • NPI 1255087003
  NPD
• North Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1972563070
  NPD (past)
• Soldiers & Sailors Memorial Hospital

  dba Soldiers & Sailors Memorial Hospital Hospitalist

  • Emergency Medicine Physician
  • Penn Yan, NY
  • NPI 1043353618
  NPD (past)
• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1457314650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 MEDICAL CENTER DR",
            "address_2": "POD C",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666600",
            "telephone_number": "315-329-4975",
            "fax_number": "315-329-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4117 MEDICAL CENTER DR",
            "address_2": "POD C",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666600",
            "telephone_number": "315-329-4975",
            "fax_number": "315-329-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL-MANTELLA",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "RNNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F330714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02245370",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Price, LMHC
• Steven A Procopio Jr., DDS
• Mark A Profetto, FNP
• Psychological Services for Self and Family, PLLC
• Ran D Anbar, Inc
• Deanna Raymond Allen, P.A
• Cary Rector, M.S., LMHC
• Tonja S. Rector, LMFT
• William C Redfield, MSW, M. DIV.
• Marilyn E Rees, MPS

• Family Nurse Practitioner in Fayetteville, NY
• Providers in Fayetteville, 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 Nov 23, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.