Individual provider Active NPI

Randi D Tomasulo, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Norwalk, CT
National Provider Identifier
1508980574
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
045676 Issued in CT
Practice address
761 Main Ave
Suite 201
Norwalk, CT 06851-1080
Phone
(203) 838-4000
Fax
(203) 845-9535
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 045676 CT Primary

Addresses

Primary practice location

761 Main Ave
Suite 201
Norwalk, CT 06851-1080

Mailing address

761 Main Ave
Suite 201
Norwalk, CT 06851-1080
Phone (203) 838-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200813001800 CT Order and Referring Only - EndocrinologyPractitioner - Endocrinology 8022102599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
045676CTMDEndocrinology, Diabetes & Metabolism Physician
045679CTMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mendelsohn Endocrinology, LLC Past 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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1508980574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE",
            "address_2": "SUITE 201",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "203-838-4000",
            "fax_number": "203-845-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE",
            "address_2": "SUITE 201",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "203-838-4000",
            "fax_number": "203-845-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMASULO",
        "first_name": "RANDI",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CT",
            "license": "045676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.