Active NPI
Randi S Wasserman
- Neonatal-Perinatal Medicine Physician
- Elmhurst, NY
National Provider Identifier
1851388771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 143376
- Practice address
- 7901 Broadway
A734
Elmhurst, NY 11373-1329 - Phone
- (718) 334-3380
- NPI assigned
- Oct 5, 2005
- 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 |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 143376 | NY | Primary |
Addresses
Primary practice location
7901 Broadway
A734
Elmhurst, NY 11373-1329
Mailing address
7901 Broadway
A734
Elmhurst, NY 11373-1329
Phone (718) 334-3380
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01501862 | Medicaid | NY |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120828000017 | NY | Order and Referring Only - Pediatric Medicine | 9032366067 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 143376 | NY | MD | Neonatal-Perinatal Medicine Physician |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440028800000",
"number": "1851388771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7901 BROADWAY",
"address_2": "A734",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731329",
"telephone_number": "718-334-3380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7901 BROADWAY",
"address_2": "A734",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731329",
"telephone_number": "718-334-3380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASSERMAN",
"first_name": "RANDI",
"middle_name": "S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-05",
"last_updated": "2015-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "NY",
"license": "143376",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01501862",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elmhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.