Individual provider Active NPI

Randi Meberg, DPM

  • Podiatrist
  • Melbourne, FL
National Provider Identifier
1710096805
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO3019 Issued in FL
Practice address
7730 N Wickham Rd
Suite 103
Melbourne, FL 32940
Phone
(321) 253-3595
Fax
(321) 253-3596
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO3019 FL Primary

Addresses

Primary practice location

7730 N Wickham Rd
Suite 103
Melbourne, FL 32940

Mailing address

7730 N Wickham Rd
Suite 103
Melbourne, FL 32940
Phone (321) 253-3595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041116000264 FL Practitioner - Podiatry 4385608173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Brevard LLCGroup PAC ID 4486558012, 75 clinicians

Practice addresses (Care Compare)

7730 N Wickham Rd
Suite 103
Melbourne, FL 32940-8296
Phone (321) 253-3595

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue207
Removal or shaving of skin growth68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO3019FLMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Brevard LLC CurrentSince Oct 15, 2009 Accepting new patients
The Foot & Ankle Institute of South Florida, Inc Podiatrist Past Accepting new patients
Meberg & Cohen LC Podiatrist PastSince Sep 17, 2004 Accepting new patients

Locations

1305 Hickory St
Melbourne, FL 32901
Phone (321) 255-1500

7730 N Wickham Rd
Ste 103
Melbourne, FL 32940
Phone (321) 253-3595

Interoperability endpoints

  • Direct secure messaging: randimeberg@mab.medentdirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1710096805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7730 N WICKHAM RD",
            "address_2": "SUITE 103",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "321-253-3595",
            "fax_number": "321-253-3596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7730 N WICKHAM RD",
            "address_2": "SUITE 103",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "321-253-3595",
            "fax_number": "321-253-3596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEBERG",
        "first_name": "RANDI",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO3019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.