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SUSAN M RANDALL-MANTELLA RNNP
NPI 1457314650
Nurse Practitioner - Family in Fayetteville, NY

Active since April 10, 2006PECOS Enrolled
94.71/100
CMS Quality Rating
4117 MEDICAL CENTER DR, POD C, FAYETTEVILLE, NY 13066(315) 329-4975(315) 329-4970 Get Directions Write a Review

NPPES record last updated: November 23, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Susan M Randall-mantella Rnnp NPPES

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

SUSAN M RANDALL-MANTELLA RNNP (NPI 1457314650) is an individual family provider in Fayetteville, New York, licensed in New York (F330714) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457314650
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSUSAN M RANDALL-MANTELLACredential: RNNP
Location Address4117 MEDICAL CENTER DR, POD CFayetteville, NY 13066-6600
Mailing Address4117 Medical Center Dr, Pod CFayetteville, NY 13066-6600 · (315) 329-4975 · Fax (315) 329-4970
Phone(315) 329-4975
Fax(315) 329-4970
Sole ProprietorNo
Enumeration DateApril 10, 2006
Last NPPES UpdateNovember 23, 2011
✔ NPI 1457314650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · F330714
4117 MEDICAL CENTER DR, Fayetteville, NY 13066
Open in Google Maps ↗

Other Identifiers 4

Medicaid02245370NY
Medicare PINJ400037547NY
Medicare UPINR89981NY
Medicare ID-Type UnspecifiedCC9198NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Susan M Randall-mantella Rnnp 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 13066 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.71/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality86.2
Promoting Interoperability91
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier14 claims14 services$14.09 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
1 supplier12 claims12 services$913.09 avg. paid by Medicare
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each E0955
DME-Wheelchairs · category DD021N
1 supplier21 claims21 services$13.75 avg. paid by Medicare
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory E1028
DME-Wheelchairs · category DD021N
1 supplier21 claims21 services$14.02 avg. paid by Medicare
Manual adult size wheelchair, includes tilt in space E1161
DME-Wheelchairs · category DD000N
1 supplier21 claims21 services$178.78 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier28 claims28 services$101.45 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 6

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

MARK A MCCONN MD PLLC
Family Medicine
4117 MEDICAL CENTER DR
FAYETTEVILLE, NY 13066
Onondaga County (315) 329-4975
LALITA SEETHARAM MD
Obstetrics & Gynecology (Gynecology)
4117 MEDICAL CENTER DR
FAYETTEVILLE, NY 13066
Onondaga County (315) 329-4968
DR. MARYANN ELIZABETH MILLAR MD
Obstetrics & Gynecology (Gynecology)
4117 MEDICAL CENTER DR, POD A
FAYETTEVILLE, NY 13066
Onondaga County (315) 329-4968
RENATE N CHEVLI MD
Obstetrics & Gynecology (Gynecology)
4117 MEDICAL CENTER DR
FAYETTEVILLE, NY 13066
Onondaga County (315) 329-4968
DAWN M SCOTT RPA
Physician Assistant (Medical)
4117 MEDICAL CENTER DR, POD C
FAYETTEVILLE, NY 13066
Onondaga County (315) 329-4968
NAVPRIYA OBEROI MD
Obstetrics & Gynecology (Gynecology)
4117 MEDICAL CENTER DR, POD A
FAYETTEVILLE, NY 13066
Onondaga County (315) 329-4968

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susan Randall-mantella's NPI number?

The NPI number for Susan Randall-mantella is 1457314650. It was assigned to this individual provider in the NPPES registry on April 10, 2006.

Where is Susan Randall-mantella located?

Susan Randall-mantella practices at 4117 Medical Center Dr Pod C, Fayetteville, NY 13066. The listed phone number is (315) 329-4975.

What is Susan Randall-mantella's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Susan Randall-mantella enrolled in Medicare?

Yes. Susan Randall-mantella is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Susan Randall-mantella was last updated on November 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.