MRS. VICTORIA PHAM RANDAZZO PHD, AG-NP, RN
NPI 1245889310
Nurse Practitioner - Gerontology in Tustin, CA

Q: What is Victoria Randazzo's NPI number?

The NPI number for Victoria Randazzo is 1245889310. It was assigned to this individual provider in the NPPES registry on September 10, 2019.

Q: What is Victoria Randazzo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Victoria Randazzo was last updated on September 10, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 10, 2019PECOS Enrolled

13522 NEWPORT AVE STE 102, TUSTIN, CA 92780(714) 573-8200(714) 573-9401 Get Directions Write a Review

NPPES record last updated: September 10, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mrs. Victoria Pham Randazzo Phd, Ag-np, Rn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. VICTORIA PHAM RANDAZZO PHD, AG-NP, RN (NPI 1245889310) is an individual gerontology provider in Tustin, California, licensed in California (95012573) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245889310

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameMRS. VICTORIA PHAM RANDAZZOCredential: PHD, AG-NP, RN

Location Address13522 NEWPORT AVE STE 102Tustin, CA 92780-3707

Mailing Address7745 E Walnut Ridge RdOrange, CA 92869-6515 · (714) 743-9494

Phone(714) 573-8200

Fax(714) 573-9401

Sole ProprietorNo

Enumeration DateSeptember 10, 2019

✔ NPI 1245889310 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in CA · 95012573

Also ListedNurse PractitionerTaxonomy 363L00000X · License 95012573 (CA)

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License 95012573 (CA)

13522 NEWPORT AVE STE 102, Tustin, CA 92780

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Other Identifiers 1

Other95012573CA · Nurse Practitioner Furnishing License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Victoria Pham Randazzo Phd, Ag-np, Rn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92780 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RICHARD CHYAN MD

Physical Medicine & Rehabilitation