Individual provider Active NPI

Jennifer Randle, OD

  • Optometrist
  • Scranton, PA
National Provider Identifier
1497857866
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001721 Issued in PA
Practice address
200 Mifflin Ave
Scranton, PA 18503
Phone
(570) 342-3145
Fax
(570) 344-1309
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001721 PA Primary

Addresses

Primary practice location

200 Mifflin Ave
Scranton, PA 18503

Mailing address

200 Mifflin Ave
Scranton, PA 18503
Phone (570) 342-3145

Other identifiers 1

IdentifierTypeStateIssuer
101631867MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060123000024 PA Practitioner - Optometry 0648294314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Eye Center, P.C.Group PAC ID 3072593508, 51 clinicians

Practice addresses (Care Compare)

3535 High Point Blvd
Bethlehem, PA 18017-7816
Phone (610) 867-9900

400 N 17TH St
Suite 101
Allentown, PA 18104-5052
Phone (610) 433-0450

Merit-based Incentive Payment System (MIPS)

Final score
82.68 of 100Reported as group
Quality
86.54
Promoting interoperability
94
Improvement activities
40
Cost
60.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Eye Center, P.C. Optometrist CurrentSince Mar 1, 2017 Accepting new patients

Locations

825 E Gate Blvd
Ste 111
Garden City, NY 11530
Phone (516) 804-5200

400 N 17th St
Ste 101
Allentown, PA 18104
Phone (215) 433-0450

3535 High Point Blvd
Ste 800
Bethlehem, PA 18017
Phone (610) 867-9900

Interoperability endpoints

  • Direct secure messaging: jennifer.randleod.p10@direct.ocli.nextgenshare.com

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1497857866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MIFFLIN AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "18503",
            "telephone_number": "570-342-3145",
            "fax_number": "570-344-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MIFFLIN AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "18503",
            "telephone_number": "570-342-3145",
            "fax_number": "570-344-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDLE",
        "first_name": "JENNIFER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101631867",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.