MR. RANDALL WARREN SUMMERVILLE PSYD
NPI 1821180803
Psychologist - Clinical in Lombard, IL

Q: What is Randall Summerville's NPI number?

The NPI number for Randall Summerville is 1821180803. It was assigned to this individual provider in the NPPES registry on September 28, 2006.

Q: What is Randall Summerville's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since September 28, 2006PECOS EnrolledAccepts Medicare Assignment

94.58/100

CMS Quality Rating

477 E BUTTERFIELD RD STE 102, LOMBARD, IL 60148(630) 424-8900(630) 424-9017 Get Directions Write a Review

NPPES record last updated: December 5, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Randall Warren Summerville Psyd NPPES

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

MR. RANDALL WARREN SUMMERVILLE PSYD (NPI 1821180803) is an individual clinical provider in Lombard, Illinois, licensed in Illinois (071-006658) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Adventist Hinsdale Hospital, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1821180803

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameMR. RANDALL WARREN SUMMERVILLECredential: PSYD

Location Address477 E BUTTERFIELD RD STE 102Lombard, IL 60148-4880

Mailing Address477 E Butterfield Rd Ste 102Lombard, IL 60148-4880 · (630) 424-8900 · Fax (630) 424-9017

Phone(630) 424-8900

Fax(630) 424-9017

Sole ProprietorYes

Medical School CMSOtherGraduated 2002

Enumeration DateSeptember 28, 2006

Last NPPES UpdateDecember 5, 2022

NPPES CertifiedNovember 29, 2022

✔ NPI 1821180803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in IL · 071-006658

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedClinical NeuropsychologistTaxonomy 103G00000X · License 071-006658 (IL)

Also ListedPsychologist · Adult Development & AgingTaxonomy 103TA0700X · License 071-006658 (IL)

477 E BUTTERFIELD RD STE 102, Lombard, IL 60148

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Other Identifiers 2

Other02233000IL · Bcbs Of Il Group Provider

Other071-0006658IL · Professional License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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

Mr. Randall Warren Summerville Psyd 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 ID244275881

PECOS Enrollment IDI20050623000418

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 12

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.

Administration of psychological or neuropsychological test by technician, each additional 30 minutes 96139

This service involves a technician administering additional psychological or neuropsychological testing. Each session lasts for an extra 30 minutes. These tests assess cognitive abilities, such as memory, attention, and problem-solving skills, to aid in diagnosing or monitoring mental health conditions.

1,252 services238 patients

Evaluation of neuropsychological test, each additional hour 96133

This service involves further evaluation of your neuropsychological test results beyond the initial hour. It helps to understand your cognitive functioning better, focusing on areas like memory, attention, and problem-solving skills.

782 services299 patients

Evaluation of neuropsychological test, first hour 96132

An evaluation of neuropsychological tests is a process to assess your brain's function. It involves tasks designed to measure cognitive abilities such as memory, attention, problem-solving, and language skills. The first hour involves initial testing and observation.

306 services301 patients

Administration of psychological or neuropsychological test, each additional 30 minutes 96137

This procedure involves administering psychological or neuropsychological tests to evaluate your mental functions. Each additional 30 minutes allows for a more in-depth assessment of your cognitive abilities, emotions, and behavior. It's crucial for accurate diagnosis and treatment planning.

291 services63 patients

Administration of psychological or neuropsychological test, each additional 30 minutes 96137

253 services78 patients

Administration of psychological or neuropsychological test by technician, first 30 minutes 96138

This procedure involves a trained technician administering a psychological or neuropsychological test. It's a process that assesses your mental function and behavior. The initial session will last 30 minutes. The aim is to understand your cognitive abilities better.

240 services238 patients

Evaluation of neuropsychological test, each additional hour 96133

166 services86 patients

Evaluation of neuropsychological test, first hour 96132

86 services86 patients

Administration of psychological or neuropsychological test, first 30 minutes 96136

This procedure involves a health professional conducting a psychological or neuropsychological test. The first 30 minutes typically involve understanding your mental health or brain function through various assessments. This helps in diagnosing and treating mental health disorders effectively.

80 services80 patients

Administration of psychological or neuropsychological test, first 30 minutes 96136

64 services64 patients

Evaluation of psychological test, first hour 96130

This procedure involves a professional assessing your mental health using standardized tests. It's the initial hour of a process that helps understand your emotional well-being and cognitive abilities. It's completely non-invasive and confidential.

23 services23 patients

Psychiatric diagnostic evaluation 90791

A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.

15 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Adventist Hinsdale Hospital

Acute Care Hospitals · Hinsdale, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140122

Location120 North Oak StHinsdale, IL 60521 · Du Page County

Emergency services Birthing friendly

Uchicago Medicine Adventhealth Bolingbrook

Acute Care Hospitals · Bolingbrook, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140304

Location500 Remington BoulevardBolingbrook, IL 60440 · Will County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60148 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

$181.38 typical visit price

range $59.81 – $181.38

Typical copayment $45.34 (range $14.95 – $45.34)

Most-billed visit code 99205

Established Patient

$105.07 typical visit price

range $19.15 – $147.12

Typical copayment $26.26 (range $4.78 – $36.78)

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.

94.58/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

73.33

Improvement Activities

Reported Quality Measures

Documentation of Current Medications in the Medical Record

100%735 patients5/55-star benchmark: 100%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

100%913 patients5/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 100% · 71 patients

100%71 patients

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Patients screened: 100% · 64 patients

100%64 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 5

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

CAROL A CREWS LCSW

Social Worker (Clinical)