Susan M Randall-mantella, RNNP - Medicare Nurse Practitioner in Fayetteville, NY

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Susan M Randall-mantella, RNNP is a medicare enrolled "Nurse Practitioner - Family" in Fayetteville, New York. Her current practice location is 4117 Medical Center Dr, Pod C, Fayetteville, New York. You can reach out to her office (for appointments etc.) via phone at (315) 329-4975.

Susan M Randall-mantella is licensed to practice in New York (license number F330714) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1457314650.

Contact Information

Susan M Randall-mantella, RNNP
4117 Medical Center Dr, Pod C,
Fayetteville, NY 13066-6600
(315) 329-4975
(315) 329-4970

Map and Direction




Provider's Profile

Full NameSusan M Randall-mantella
GenderFemale
SpecialityNurse Practitioner - Family
Location4117 Medical Center Dr, Fayetteville, New York
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1457314650
  • Provider Enumeration Date: 04/10/2006
  • Last Update Date: 11/23/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 0941394845
  • Enrollment ID: I20070924000125

Medical Identifiers

Medical identifiers for Susan M Randall-mantella such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1457314650NPI-NPPES
02245370MedicaidNY

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family F330714 (New York)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Susan M Randall-mantella allows following entities to bill medicare on her behalf.
Entity NameJoseph A Lorenzetti
Entity TypePractitioner - Family Practice
Entity IdentifiersNPI Number: 1336174457
PECOS PAC ID: 8527158484
Enrollment ID: I20071214000532
Entity NameGeneva General Hospital, Inc
Entity TypePart B Supplier - Hospital Department(s)
Entity IdentifiersNPI Number: 1215194501
PECOS PAC ID: 7810809407
Enrollment ID: O20080728000487
Entity NameFlh Medical Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1215174644
PECOS PAC ID: 6507922358
Enrollment ID: O20090304000165
Entity NameSoldiers & Sailors Memorial Hospital
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1215044516
PECOS PAC ID: 0446164255
Enrollment ID: O20210407000450

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Susan M Randall-mantella is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Susan M Randall-mantella, RNNP
4117 Medical Center Dr, Pod C,
Fayetteville, NY 13066-6600

Ph: (315) 329-4975		Susan M Randall-mantella, RNNP
4117 Medical Center Dr, Pod C,
Fayetteville, NY 13066-6600

Ph: (315) 329-4975

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.