Melissa Randazzo, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA1059350 Issued in NJ

Practice address

College Plaza Pediatrics
765 Route 10 East, Ste 203
Randolph, NJ 07869

Phone

(973) 659-9991

Fax

(973) 659-9632

NPI assigned

Jun 27, 2017

Last updated

Oct 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• College Plaza Pediatrics

  • Pediatrics Physician
  • Randolph, NJ
  • NPI 1417083403
  NPD (past)

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1053831479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COLLEGE PLAZA PEDIATRICS",
            "address_2": "765 ROUTE 10 EAST, STE 203",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "07869",
            "telephone_number": "973-659-9991",
            "fax_number": "973-659-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COLLEGE PLAZA PEDIATRICS",
            "address_2": "765 ROUTE 10 EAST, STE 203",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "07869",
            "telephone_number": "973-659-9991",
            "fax_number": "973-659-9632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDAZZO",
        "first_name": "MELISSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA1059350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Vito Racanelli, DDS
• Shannon Jeanne Radkovich, PA-C
• Christina Rafanelli
• Shraddha Raghavan, MD
• Nishan George Rajaratnam, MD
• Randolph Center for Oral and Maxillofacial Surgery, LLC
• Randolph Center for Oral and Maxillofacial Surgery, PA
• Randolph Dental Care
• Randolph Dermatology and Mohs Micrographic Surgery LLC
• Randolph Eyecare Center PA

• Pediatrics Physician in Randolph, NJ
• Providers in Randolph, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.