Individual provider Active NPI

Randy M Seewald, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1912972548
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1799471 Issued in NY
Practice address
1825 Park Ave
New York, NY 10035-1641
Phone
(212) 774-3250
NPI assigned
Feb 17, 2006
Last updated
Dec 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1799471 NY Primary

Addresses

Primary practice location

1825 Park Ave
New York, NY 10035-1641

Mailing address

1825 Park Ave
New York, NY 10035-1641
Phone (212) 774-3250

Other identifiers 1

IdentifierTypeStateIssuer
01152625MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20220920000756 NJ Practitioner - Addiction Medicine 1456333608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1799471NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Choicepoint LLC Internal Medicine CurrentSince Aug 10, 2022 Accepting new patients
Choicepoint LLC CurrentSince Aug 10, 2022 Accepting new patients
Bimc Faculty Practice Past Accepting new patients
Beth Israel Medical Center Internal Medicine Past Accepting new patients

Locations

6586 Atlantic Ave
Delray Beach, FL 33446
Phone (203) 240-0426

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ridgefield Visiting Nurse AssociationRidgefield, CT, CCN 071545 Hospice W-2 Managing Employee Dec 4, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1912972548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351641",
            "telephone_number": "212-774-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351641",
            "telephone_number": "212-774-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEEWALD",
        "first_name": "RANDY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1799471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01152625",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.