Jessica Leung Randalls, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

54982 Issued in CA

Practice address

605 Crouch St
Oceanside, CA 92054-4415

Phone

(760) 736-7676

NPI assigned

Oct 1, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrandalls313253@direct.ochin.org

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.

• North County Health Project Inc

  • Federally Qualified Health Center (FQHC)
  • San Marcos, CA
  • NPI 1245246917
  Medicare reassignment
• North County Health Project Inc

  • Federally Qualified Health Center (FQHC)
  • Oceanside, CA
  • NPI 1033980875
  NPD
• North County Health Project Inc

  • Federally Qualified Health Center (FQHC)
  • San Marcos, CA
  • NPI 1588489975
  NPD
• Tri-City Hospital

  • General Acute Care Hospital
  • Oceanside, CA
  • NPI 1801861190
  NPD (past)

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1538410550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 CROUCH ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920544415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 CROUCH ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920544415",
            "telephone_number": "760-736-7676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E 65th St",
            "address_2": "Yaffe Ruden Associates",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100656701",
            "country_code": "US",
            "telephone_number": "212-879-4700",
            "fax_number": "212-750-9654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDALLS",
        "first_name": "JESSICA",
        "middle_name": "LEUNG",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-01",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "016061",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rancho Physical Therapy, Inc.
• Rancho Santa Fe Medical Group, Inc.
• Rancho Santa Fe Medical Group, Inc.
• Emely Randall, LVN
• Kristy Randall, LCSW
• Margo Janeen Randolph, MSW, LCSW
• Sylvia M Raslan
• Anuja S Raste, MS
• Nikhilkumar Raval, M.D.
• Nicole Kirsten Raymundo, R.N.

• Physician Assistant in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; 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.