Active NPI
Randall J Paye, O.D.
- Optometrist
- Green Bay, WI
National Provider Identifier
1508903766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1546-035
- Practice address
- 1515 6TH St
Green Bay, WI 54304-2272 - Phone
- (920) 499-2147
- Fax
- (920) 499-0574
- NPI assigned
- Jan 30, 2007
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1546-035 | WI | Primary |
Addresses
Primary practice location
1515 6TH St
Green Bay, WI 54304-2272
Mailing address
1515 6TH St
Green Bay, WI 54304-2272
Phone (920) 499-2147
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1546-035 | Other | WI | STATE LICENSE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1546-035 | WI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myeyedr Optometry of Wisconsin, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Wisconsin, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Wisconsin, LLC | Optometrist | Current | Accepting new patients |
Locations
1950 Old Gallows Rd
Ste 520
Vienna, VA 22182
1515 6th St
Green Bay, WI 54304
Phone (920) 499-2147
2305 30th Ave
Kenosha, WI 53144
Phone (262) 597-2020
Organizations & group practices 3
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1508903766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 6TH ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543042272",
"telephone_number": "920-499-2147",
"fax_number": "920-499-0574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 6TH ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543042272",
"telephone_number": "920-499-2147",
"fax_number": "920-499-0574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYE",
"first_name": "RANDALL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "1546-035",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE #",
"identifier": "1546-035",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.