Michael L Randall, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200458 Issued in NY

Practice address

2539 Middle Country Road
Centereach, NY 11720

Phone

(631) 580-1740

Fax

(631) 580-9155

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Eric Spronz, Psychiatric Nurse Practitioner P.C.

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  • NPI 1063029411
  NPD
• Smithtown Primary Medical Care, P.C.

  • Family Medicine Physician
  • Smithtown, NY
  • NPI 1326243536
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1639196108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 MIDDLE COUNTRY ROAD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "11720",
            "telephone_number": "631-580-1740",
            "fax_number": "631-580-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 MIDDLE COUNTRY ROAD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "11720",
            "telephone_number": "631-580-1740",
            "fax_number": "631-580-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "200458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rita Provinciali, RN
• Julianne Purpura
• Debra Lee Quinn, LPN
• Kailey Lyn Quirk, LPN
• Michael J Quirk, RN
• Kamlesh Rani, LPN
• Kerry Reardon - Bossone
• Steven Reshey, LCSW
• Respi Sleep Consulting Inc.
• Grace Ann Reynolds Victor, LCSW

• Family Medicine Physician in Centereach, NY
• Providers in Centereach, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.