Frederick William Randolph, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

D0019085 Issued in MD

Practice address

2607 Rhawn St
Philadelphia, PA 19152-3038

Phone

(215) 333-0304

Fax

(215) 333-1402

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jefferson Acute Care Physicians, PC

  • Urgent Care Clinic/Center
  • Philadelphia, PA
  • NPI 1730571324
  Medicare reassignment NPD
• Jefferson Acute Care Physicians, PC

  • Urgent Care Clinic/Center
  • Flourtown, PA
  • NPI 1245892314
  NPD
• Eagle Emergency Physicians LLC

  • Emergency Medicine Physician
  • Coudersport, PA
  • NPI 1538193248
  NPD (past)
• Professional Emergency Care, PC

  • Emergency Medicine Physician
  • Honesdale, PA
  • NPI 1861671091
  NPD (past)
• Emergency Physician Associates of Maryland, P.C.

  • Emergency Medicine Physician
  • Baltimore, MD
  • NPI 1740213453
  NPD (past)
• Hospital Physician Services, LLLP

  • General Acute Care Hospital
  • Westminster, MD
  • NPI 1457302713
  NPD (past)
• Yardmore Emergency Physicians LLC

  • Emergency Medicine Physician
  • Baltimore, MD
  • NPI 1730131657
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1033155247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 RHAWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523038",
            "telephone_number": "215-333-0304",
            "fax_number": "215-333-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 RHAWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523038",
            "telephone_number": "215-333-0304",
            "fax_number": "215-333-1402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2966 Street Rd",
            "address_purpose": "LOCATION",
            "city": "Bensalem",
            "state": "PA",
            "postal_code": "190202604",
            "country_code": "US",
            "telephone_number": "215-638-0666",
            "fax_number": "215-638-3320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2451 Grant Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191141031",
            "country_code": "US",
            "telephone_number": "215-934-3471",
            "fax_number": "215-934-3472",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2021 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191033373",
            "country_code": "US",
            "telephone_number": "267-443-2020",
            "fax_number": "215-640-8860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191063505",
            "country_code": "US",
            "telephone_number": "215-503-7300",
            "fax_number": "215-503-5666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "FREDERICK",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0019085",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD447333",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "368731700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10433266",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandip Kaur Randhawa, OD
• Emily Randle
• Jennifer Rando, MT-BC
• Randolph Walters & Associates, LLC
• Frederick Randolph, MD
• Khadijah Randolph, LPN
• Norman D. Randolph Jr., MD
• Sadia Randolph
• Toni Diahann Randolph
• Rands Helping Hands Home Care LLC

• Emergency Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.