Individual provider Active NPI

Randy M Martinelli, L.D.O.

  • Optician
  • Palm Beach Gardens, FL
National Provider Identifier
1598821902
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
FL3876 Issued in FL
Practice address
2514 Pga Blvd
Palm Beach Gardens, FL 33410-2902
Phone
(561) 500-8884
Fax
(561) 500-8885
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X FL3876 FL Primary

Addresses

Primary practice location

2514 Pga Blvd
Palm Beach Gardens, FL 33410-2902

Mailing address

5062 West Atlantic Ave
Delray Beach, FL 33484-8129
Phone (561) 498-8884

Other practice location 1

5062 West Atlantic Ave
Delray Beach, FL 33484-8129
Phone (561) 498-8884

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
FL3876FLMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Benjamin F Anderson Jr OD PA 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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1598821902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5062 WEST ATLANTIC AVE",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334848129",
            "telephone_number": "561-498-8884",
            "fax_number": "561-498-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 PGA BLVD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102902",
            "telephone_number": "561-500-8884",
            "fax_number": "561-500-8885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5062 West Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334848129",
            "country_code": "US",
            "telephone_number": "561-498-8884",
            "fax_number": "561-498-7878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINELLI",
        "first_name": "RANDY",
        "middle_name": "M",
        "credential": "L.D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "FL3876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.