Active NPI
Julie C Randall, PT
- Physical Therapist
- East Syracuse, NY
National Provider Identifier
1629006473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 020542-1
- Practice address
- 6319 Fly Rd
Suite 3
East Syracuse, NY 13057-9357 - Phone
- (315) 410-6200
- Fax
- (315) 451-2095
- NPI assigned
- Jun 29, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 020542-1 | NY | Primary |
Addresses
Primary practice location
6319 Fly Rd
Suite 3
East Syracuse, NY 13057-9357
Mailing address
7455 Morgan Rd
Suite 2
Liverpool, NY 13090-3956
Phone (315) 451-6767
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 161303109 | Other | NY | CIGNA |
| 000131712 | Other | NY | BSCNY |
| 000921584005 | Other | NY | HEALTHNOW NY |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020542-1 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fitness Forum Physical Therapy, PC | Physical Therapist | Past | Accepting new patients |
| Encompass Health Rehabilitation Hospital of Florence, Inc. | Past | Accepting new patients | |
| Onondaga Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapist
- Syracuse, NY
- NPI 1710923222
-
- Physical Therapist
- Baldwinsville, NY
- NPI 1548367139
-
- Rehabilitation Hospital
- Florence, SC
- NPI 1598738296
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397779200000",
"number": "1629006473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7455 MORGAN RD",
"address_2": "SUITE 2",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130903956",
"telephone_number": "315-451-6767",
"fax_number": "315-451-0569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6319 FLY RD",
"address_2": "SUITE 3",
"city": "EAST SYRACUSE",
"state": "NY",
"postal_code": "130579357",
"telephone_number": "315-410-6200",
"fax_number": "315-451-2095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "JULIE",
"middle_name": "C",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-29",
"last_updated": "2014-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "020542-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "161303109",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSCNY",
"identifier": "000131712",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNOW NY",
"identifier": "000921584005",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.