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JACLYN RANDEL MD NPI 1386624591


NPI Information

NPI: 1386624591
Provider Name: JACLYN RANDEL, MD
Classification: Family Medicine - 207QA0401X
Entity Type: Individual

Specialization: Addiction Medicine

PECOS Registration: Yes

Address:
5333 MCAULEY DR RM 5011
YPSILANTI, MI
ZIP 48197
Phone: (734) 622-5016
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Jaclyn Randel, MD is an addiction medicine family medicine in Ypsilanti, MI with 35 years of experience. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. Jaclyn Randel, MD NPI is 1386624591. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1989

The provider's business location address is:

5333 MCAULEY DR RM 5011
YPSILANTI, MI
ZIP 48197-003
Phone: (734) 622-5016
Fax: (734) 622-5017

The NPI 1386624591 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Testing for presence of drug (HCPCS:80305)

The enumeration date for this NPI number is 1/23/2006 and was last updated on 6/13/2019.


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
1207Q00000XFamily Medicine4301054205MICHIGANNo
2207QA0401XFamily MedicineAddiction Medicine4301054205MICHIGANYes

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.