MRS. LISA MARIE RANDON M.D.
NPI 1316088644
Pediatrics in Detroit, MI

Q: What is Lisa Randon's NPI number?

The NPI number for Lisa Randon is 1316088644. It was assigned to this individual provider in the NPPES registry on February 9, 2007. The provider is also known as Miss Lisa Marie Harrell.

Q: What is Lisa Randon's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Randon was last updated on February 14, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 February 09, 2007PECOS Enrolled

2395 W GRAND BLVD, DETROIT, MI 48208(313) 831-2442(313) 831-2442 Get Directions Write a Review

NPPES record last updated: February 14, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Mrs. Lisa Marie Randon M.d. NPPES

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

MRS. LISA MARIE RANDON M.D. (NPI 1316088644) is an individual pediatrics provider in Detroit, Michigan, licensed in Michigan (4301068207) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316088644

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameMRS. LISA MARIE RANDONCredential: M.D.

Location Address2395 W GRAND BLVDDetroit, MI 48208-1210

Mailing Address1511 Brooklyn StDetroit, MI 48226-1007 · (313) 608-1510

Phone(313) 831-2442

Fax(313) 831-2442

Sole ProprietorNo

Enumeration DateFebruary 9, 2007

Last NPPES UpdateFebruary 14, 2017

✔ NPI 1316088644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in MI · 4301068207

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

2395 W GRAND BLVD, Detroit, MI 48208

Open in Google Maps ↗

Other Names 1

Former Name (1)Miss Lisa Marie Harrell

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Priority Health, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Lisa Marie Randon M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Lisa Randon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Detroit Community Health Connection, Inc

2.1 mi

Federally Qualified Health Center (FQHC)

611 MARTIN LUTHER KING JR BLVD
Detroit, MI 48201

Reassigned Medicare billing, Michigan enrollment
23 clinicians in this Medicare group

NPI 1790948982 (313) 832-6300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48208 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

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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 7

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

DR. DAVID ALTON APRAHAMIAN D.O.

Family Medicine