Randall Solomon

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

174711 Issued in NY

Practice address

55 Nesconset Hwy
Suite 1
Port Jefferson Station, NY 11776-2631

Phone

(631) 474-8099

NPI assigned

Jan 10, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

State University of New York at Buffalo School of Medicine, 1984

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Island Psychiatry PCGroup PAC ID 9032490610, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Island Psychiatry, P.C.

  • Cognitive & Behavioral Psychologist
  • Port Jefferson, NY
  • NPI 1609249754
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780733360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NESCONSET HWY",
            "address_2": "SUITE 1",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762631",
            "telephone_number": "631-474-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NESCONSET HWY",
            "address_2": "SUITE 1",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762631",
            "telephone_number": "631-474-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "RANDALL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "174711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01112610",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Lynn Smith
• Kayla Anne Snyder
• Social Work for Counseling for Inspirational Living LCSW PC
• Danielle Maria Sohngen
• Mario Solomita, DO
• Sonshine Counseling & Consulting LLC
• Sophia a Argeropoulos DC PC
• Erin Elizabeth Sorger, MA CCC-SLP
• Robert Soucy, INC.
• Sound Gastroenterology, P.C.

• Psychiatry Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.