Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Individual
RANDAL LUCAS SHELLY
Active
Individual
RANDAL LUCAS SHELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OS010845L
PA
208M00000X
Hospitalist Physician
Primary
OS010845L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018237650007
—
PA
01
—
080180776
RAILROAD MEDICARE
PA
01
—
1007307260034
MEDICAID GROUP #
PA
01
—
120420410
DEPT OF LABOR
PA
01
—
1533687
GATEWAY (WH)
PA
01
—
172970
UNISON
PA
01
—
2198371
FIRST HEALTH
PA
01
—
25-1716306
HEALTHNET/TRICARE
PA
01
—
277524
MAMSI
PA
01
—
2890315
AETNA HMO
PA
01
—
308445
HEALTH AMERICA
PA
01
—
50045001
CAPITAL BLUECROSS (CH)
PA
01
—
50087606
CAPITAL BLUECROSS (WH)
PA
01
—
7437368
AETNA NON-HMO
PA
01
—
85320
HIGHMARK BLUESHIELD
PA
01
—
867633
MEDICARE GROUP #
PA
01
—
OS010845L
LICENSE
PA
01
—
P006022
GATEWAY (CH)
PA
Enumeration date
08/09/2005
Last updated
04/07/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up