JEFFREY RANDALL
NPI 1053782656
Social Worker - Clinical in Portland, OR

NPI Status: Active since October 08, 2015

Contact Information

3500 NE MLK BLVD STE 200
PORTLAND, OR
ZIP 97212
Phone: (503) 327-8205

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  • Individual
  • Male
  • Social Worker
  • Clinical
  • Accepts Insurance
  • Opted-Out Medicare

About JEFFREY RANDALL

This page provides the complete NPI Profile along with additional information for Jeffrey Randall, a provider established in Portland, Oregon with a medical specialization in Social Worker, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1053782656 assigned on October 2015. The practitioner's primary taxonomy code is 1041C0700X with license number L7994 (OR). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1053782656
Provider Name
JEFFREY RANDALL
Gender
Male
Entity Type
Individual
Location Address
3500 NE MLK BLVD STE 200 PORTLAND, OR 97212
Location Phone
(503) 327-8205
Mailing Address
PO BOX 82819 PORTLAND, OR 97282
Is Sole Proprietor?
Yes
Enumeration Date
10-08-2015
Last Update Date
03-12-2019
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A clinical social worker like Jeffrey Randall is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Jeffrey Randall opted out of Medicare effective on 04-01-2024 until 04-01-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Social Worker Clinical

Taxonomy Code
1041C0700X
Type
Behavioral Health & Social Service Providers
License No.
L7994
License State
OR
Taxonomy Description
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Silver - EPO
  • Clear Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - EPO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - EPO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - EPO
  • Focused Silver + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Principal Bronze HSA - EPO
  • Principal Bronze HSA + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Opted-Out of Medicare? Yes

  • Opt-Out Effective Date: 04-01-2024

  • Opt-Out End Date: 04-01-2026

  • Eligible to Order and Refer? No

Reviews for JEFFREY RANDALL

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1053782656, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
3
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
8
Unchanged
Pos 7
2
Doubled → 4
Pos 8
6
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 7 → 14 → 5 2 → 4 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 0 + 3 + 1 + 4 + 8 + 4 + 6 + 1 + 0 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1053782656.

Other Providers at the Same Location


The following 14 providers are registered at the same or a nearby location.

Student in an Organized Health Care Education/Training Program
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Student in an Organized Health Care Education/Training Program
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Case Manager/Care Coordinator
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Behavior Analyst
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Counselor (Mental Health)
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Counselor (Mental Health)
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Social Worker
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Counselor (Professional)
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Counselor
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Counselor (Mental Health)
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Counselor (Professional)
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Psychiatry & Neurology (Psychiatry)
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Counselor (Professional)
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Social Worker (Clinical)
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053782656, enumerated as an "individual" on October 08, 2015.

The provider is located at 3500 NE MLK BLVD STE 200 PORTLAND, OR 97212 and the phone number is (503) 327-8205.

Social Worker with taxonomy code 1041C0700X and a focus in Clinical.

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from NH. Please consult your insurance carrier or call the provider to verify.