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NPI Code Detail

MEDICARE: MR. RANDALL JAMES SORRENTINO PA-C

MEDICARE: MR. RANDALL JAMES SORRENTINO PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies7034950001AZ
2363A00000XPhysician Assistant3649AZ
3332B00000XDurable Medical Equipment & Medical Supplies7209350001AZ
4332B00000XDurable Medical Equipment & Medical Supplies7046960001AZ
5332B00000XDurable Medical Equipment & Medical Supplies7057360001AZ
6332B00000XDurable Medical Equipment & Medical Supplies7047150001AZ
7332B00000XDurable Medical Equipment & Medical Supplies7045160001AZ
8332B00000XDurable Medical Equipment & Medical Supplies7629170001AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13649OTHERAZARIZONA LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588647374
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RANDALL JAMES SORRENTINO PA-C
Provider Business Mailing Address
First Line : 3260 N HAYDEN RD STE 112
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-6650
Country : US
Telephone Number : 602-264-9100
Fax Number : 602-264-9101
Provider Business Practice Location Address
First Line : 14044 W CAMELBACK RD STE 118
Second Line :
City : LITCHFIELD PARK
State : AZ
Zip : 85340-9481
Country : US
Telephone Number : 623-547-2600
Fax Number : 623-547-1899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2005
Last Update Date : 01/08/2026

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