Randy Widtfeldt, PA
Physician Assistant, Surgical in Stoneham, Massachusetts
1487089504- Practice location
- 92 Montvale Ave, Stoneham, MA 02180-3647
- Phone
- 781-279-7040
- Fax
- —
- Last updated
- July 6, 2026
Randy Widtfeldt is a Physician Assistant, Surgical based in Stoneham, MA. Randy Widtfeldt practices in Stoneham, MA and has the professional credentials of PA. The NPI Number for Randy Widtfeldt is 1487089504 and holds a License No. PA4822 (MA). The current practice location address for Randy Widtfeldt is 92 Montvale Ave, Stoneham, MA 02180-3647 and can be reached out via phone at 781-279-7040.
Provider Profile Details
- NPI Number
- 1487089504
- Provider Name
- Randy Widtfeldt
- Credential
- PA
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 92 Montvale Ave, Stoneham, MA 02180-3647
- Phone Number
- 781-279-7040
- Primary Taxonomy
- Physician Assistant, Surgical · 363AS0400X
- Sole Proprietor
- No
- Provider Enumeration Date
- September 9, 2013
- Last Update Date
- July 6, 2026
- Certification Date
- July 6, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 92 Montvale Ave
Stoneham, MA 02180-3647 - City
- Stoneham
- State
- Massachusetts
- Zip
- 02180-3647
- Phone Number
- 781-279-7040
Provider Business Mailing Address Details
- Address
- 92 Montvale Ave
Ste 1400
Stoneham, MA 02180-3629 - City
- Stoneham
- State
- MA
- Zip
- 02180-3629
- Phone Number
- 781-279-7040
- Fax Number
- 781-279-8430
License Information
- License Number
- PA4822
- License State
- MA
- Taxonomy
- Physician Assistant, Surgical · 363AS0400X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Physician Assistant, Surgical providers near Stoneham, MA
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Frequently Asked Questions
What is the NPI number of Randy Widtfeldt, PA?
The NPI number of Randy Widtfeldt, PA is 1487089504. It was assigned on September 9, 2013 and is currently active in the NPPES registry.
What is the specialty of Randy Widtfeldt, PA?
Randy Widtfeldt, PA is registered under the primary taxonomy Physician Assistant, Surgical (code 363AS0400X), licensed in MA under license number PA4822.
Where does Randy Widtfeldt, PA practice?
The practice location is 92 Montvale Ave, Stoneham, MA 02180-3647. The office can be reached at 781-279-7040 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1487089504 directly on the NPPES registry website.