Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

RANDY WIDTFELDT PA
NPI 1487089504
Physician Assistant - Surgical in Stoneham, MA

Q: What is Randy Widtfeldt's NPI number?

The NPI number for Randy Widtfeldt is 1487089504. It was assigned to this individual provider in the NPPES registry on September 9, 2013.

Q: What is Randy Widtfeldt's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Randy Widtfeldt was last updated on July 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 53 days 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 09, 2013PECOS EnrolledAccepts Medicare Assignment

92 MONTVALE AVE, STONEHAM, MA 02180(781) 279-7040 Get Directions Write a Review

NPPES record last updated: July 6, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jul 6, 2026, Jul 14, 2021, Feb 3, 2017 (3 updates tracked since 2017).

On this page

About Randy Widtfeldt Pa NPPES

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

RANDY WIDTFELDT PA (NPI 1487089504) is an individual surgical provider in Stoneham, Massachusetts, licensed in Massachusetts (PA4822) and active in the NPI registry since September 2013. He is enrolled in Medicare PECOS, is affiliated with Melrosewakefield Healthcare, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1487089504

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameRANDY WIDTFELDTCredential: PA

Location Address92 MONTVALE AVEStoneham, MA 02180-3647

Mailing Address92 Montvale Ave, Ste 1400Stoneham, MA 02180-3629 · (781) 279-7040 · Fax (781) 279-8430

Phone(781) 279-7040

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateSeptember 9, 2013

Last NPPES UpdateJuly 6, 20263 updates tracked since enumeration

NPPES CertifiedJuly 6, 2026

✔ NPI 1487089504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in MA · PA4822

92 MONTVALE AVE, Stoneham, MA 02180

Open in Google Maps ↗

Secondary Practice Locations 3

Location 144 Bearfoot Rd Ste 3125Northborough, MA 01532-1559 · Phone (781) 279-7040 · Fax (781) 279-8430

Location 2405 Pearl StMalden, MA 02148-6644 · Phone (781) 665-9500 · Fax (781) 665-3856

Location 3362 Belmont StBrockton, MA 02301-4950 · Phone (781) 279-7040 · Fax (781) 279-8430

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Randy Widtfeldt Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082840731

PECOS Enrollment IDI20131202001056

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

42 services42 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

39 services39 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Melrosewakefield Healthcare

Acute Care Hospitals · Melrose, MA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220070

Location585 Lebanon StreetMelrose, MA 02176 · Middlesex County

Emergency services Birthing friendly

Winchester Hospital

Acute Care Hospitals · Winchester, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220105

Location41 Highland AvenueWinchester, MA 01890 · Middlesex County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

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

KRISTIN KAZZI PA-C

Physician Assistant

92 MONTVALE AVE
STONEHAM, MA 02180

Middlesex County (617) 500-2669

DR. ROBERT P WAUGH MD

Orthopaedic Surgery

92 MONTVALE AVE
STONEHAM, MA 02180

Middlesex County (781) 279-7040

DR. JULIANNE STOUGHTON MD

Surgery

92 MONTVALE AVE, SUITE 3200
STONEHAM, MA 02180

Middlesex County (781) 438-8117

MR. CRAIG ALEXANDER HANSEN I

Physical Therapist (Orthopedic)

92 MONTVALE AVE, STE 1400
STONEHAM, MA 02180

Middlesex County (617) 591-4655

MS. BRIGID MARIA SCHIANO LICSW

Social Worker (Clinical)

92 MONTVALE AVE
STONEHAM, MA 02180

Middlesex County (781) 438-4300

KIMBERLY B TIGHE PA

Physician Assistant

92 MONTVALE AVE, SUITE 1400
STONEHAM, MA 02180

Middlesex County (781) 279-7040

DR. PETER ELLZEY GEE M.D.

Specialist

92 MONTVALE AVE, STONEHAM
STONEHAM, MA 02180

Middlesex County (781) 662-2229

MRS. JEAN WYATT GEE N.P.-C

Nurse Practitioner (Primary Care)

92 MONTVALE AVE, 4605
STONEHAM, MA 02180

Middlesex County (781) 662-2229

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 Randy Widtfeldt's NPI number?

The NPI number for Randy Widtfeldt is 1487089504. It was assigned to this individual provider in the NPPES registry on September 9, 2013.

Where is Randy Widtfeldt located?

Randy Widtfeldt practices at 92 Montvale Ave, Stoneham, MA 02180. The listed phone number is (781) 279-7040.

What is Randy Widtfeldt's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Randy Widtfeldt enrolled in Medicare?

Yes. Randy Widtfeldt is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Randy Widtfeldt accept?

Health plans from Anthem Blue Cross and Blue Shield list Randy Widtfeldt as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Randy Widtfeldt affiliated with any hospitals?

According to CMS data, Randy Widtfeldt is affiliated with Melrosewakefield Healthcare and Winchester Hospital.

When was this NPI record last updated?

The NPPES record for Randy Widtfeldt was last updated on July 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 53 days 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.