Randal H Medzoyan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD074434L Issued in PA

Practice address

1251 E Main St
Annville, PA 17003

Phone

(717) 867-4671

NPI assigned

Jul 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rmedzoyan296368@upmc.direct-ci.com

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.

• Pinnacle Health Medical Services

  • Family Medicine Physician
  • Harrisburg, PA
  • NPI 1932143427

  Pediatrics

  Medicare reassignment NPD
• Pinnacle Health Medical Services

  • Gastroenterology Physician
  • Mechanicsburg, PA
  • NPI 1295552073
  NPD
• Pinnacle Health Medical Services

  • Colon & Rectal Surgery Physician
  • Harrisburg, PA
  • NPI 1831605427
  NPD

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1831114768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST STE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612",
            "telephone_number": "717-867-4671",
            "fax_number": "717-867-4981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 E MAIN ST",
            "city": "ANNVILLE",
            "state": "PA",
            "postal_code": "17003",
            "telephone_number": "717-867-4671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "618 Cornwall Rd",
            "address_2": "Building 2",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "17042",
            "country_code": "US",
            "telephone_number": "717-279-6700",
            "fax_number": "717-279-6759",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "618 Cornwall Rd",
            "address_2": "Building 2",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "17042",
            "country_code": "US",
            "telephone_number": "717-279-6700",
            "fax_number": "717-279-6759",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "618 Cornwall Rd",
            "address_2": "Building 2",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "17042",
            "country_code": "US",
            "telephone_number": "717-279-6700",
            "fax_number": "717-279-6759",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "618 Cornwall Rd",
            "address_2": "Building 2",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "17042",
            "country_code": "US",
            "telephone_number": "717-279-6700",
            "fax_number": "717-279-6759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDZOYAN",
        "first_name": "RANDAL",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD074434L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101339107",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmedzoyan64189@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "1251 E Main St",
            "city": "Annville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "17003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kendra Major
• Makch, LLC
• Victoria Manmiller
• Jesse Paul Martin, LPC, NCC
• Christine Dolores Mazurkiewicz, LMFT
• Melissa Mellon, P.A.
• Jessica Ann Melnikov, DMD
• Kristi Rey Mennitto, D.C.
• Hannah Kate Miller, PA-C
• Michele Lyn Miller, LMFT

• Pediatrics Physician in Annville, PA
• Providers in Annville, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.