Individual provider Active NPI

David Michael Rando, PTA

  • Physical Therapy Assistant
  • Horseheads, NY
National Provider Identifier
1497465959
Registry record updated Nov 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
007905-01 Issued in NY
Practice address
168 Miller St
Horseheads, NY 14845-1854
Phone
(607) 767-6190
NPI assigned
Nov 24, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 007905-01 NY Primary

Addresses

Primary practice location

168 Miller St
Horseheads, NY 14845-1854

Mailing address

315 Glenmary Dr
Owego, NY 13827
Phone (607) 687-8821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
007905-01NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Select PT, OT & SLP Rehabilitation Ny PLLC PastSince Nov 27, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1669248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669248000000",
    "number": "1497465959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 GLENMARY DR",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "13827",
            "telephone_number": "607-687-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 MILLER ST",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148451854",
            "telephone_number": "607-767-6190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDO",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-24",
        "last_updated": "2022-11-24",
        "certification_date": "2022-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "007905-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Horseheads, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.