GLENN R RANDALL MD NPI 1033170972

NPI Information

NPI: 1033170972
Provider Name: GLENN R RANDALL, MD
Classification: Internal Medicine - 207RG0300X
Entity Type: Individual

Specialization: Geriatric Medicine

Address:
277 EAST MOUNTAIN ST
SUMMIT ELDERCARE
WORCESTER, MA
ZIP 01606
Phone: (508) 852-2026
Get Directions

Glenn R Randall, MD is a geriatric medicine internal medicine in Worcester, MA. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. Glenn R Randall, MD NPI is 1033170972. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

277 EAST MOUNTAIN ST
SUMMIT ELDERCARE
WORCESTER, MA
ZIP 01606
Phone: (508) 852-2026
Fax: (508) 856-7130

The enumeration date for this NPI number is 3/30/2006 and was last updated on 1/17/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		80026	MASSACHUSETTS	No
2	207RH0002X	Internal Medicine	Hospice and Palliative Medicine	80026	MASSACHUSETTS	No
3	207RG0300X	Internal Medicine	Geriatric Medicine	80026	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	042472266	OTHER		HEALTHCARE VALUE MGMT
2	042472266	OTHER		PRIVATE HEALTHCARE SYSTEM
3	1061182	OTHER		FIRST HEALTH
4	110175052	OTHER		RAILROAD MEDICARE
5	6633909	OTHER		CIGNA HEALTH PLAN
6	7001328	OTHER		AETNA US HEALTHCARE
7	784073	OTHER		MVP HEALTH CARE
8	042472266	OTHER		ONE HEALTH PLAN
9	27190	OTHER		CHILDRENS MED SEC PLAN
10	27190	OTHER		HEALTHY START
11	E87046	MEDICARE UPIN
12	J14922	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS
13	991122	OTHER		FALLON COMMUNITY HEALTH P
14	AA2364	OTHER		HARVARD PILGRIM HEALTHCAR
15	J14922	OTHER		BLUE CARE ELECT
16	J14922	OTHER		BLUE SHIELD HMO BLUE
17	0400961	OTHER		EVERCARE
18	J14922	OTHER		MEDICARE B
19	3131335	MEDICAID	MASSACHUSETTS
20	J14922	OTHER		BLUE SHIELD INDEMNITY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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