Cleveland W Randolph Jr., M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME42493 Issued in FL

Practice address

1891 Beach Blvd
Ste. 200
Jacksonville Beach, FL 32250-2644

Phone

(904) 249-3743

Fax

(904) 249-2047

NPI assigned

Sep 23, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Obstetrics/Gynecology

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleveland W. Randolph, Jr, MD, PAGroup PAC ID 5496749004, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drrandolphsagelessandaellness.cwrandolph@126165.advancedmd-direct.com

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.

• Cleveland W Randolph, Jr, MD, PA

  • Specialist
  • Jacksonville Beach, FL
  • NPI 1497808182
  Medicare reassignment Care Compare group NPD
• North Florida Obstetrical and Gynecological Associates PA

  • Obstetrics & Gynecology Physician
  • Jacksonville, FL
  • NPI 1316907926
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219017600000",
    "number": "1124014287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 BEACH BLVD",
            "address_2": "STE. 200",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502644",
            "telephone_number": "904-249-3743",
            "fax_number": "904-249-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 BEACH BLVD",
            "address_2": "STE. 200",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502644",
            "telephone_number": "904-249-3743",
            "fax_number": "904-249-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "CLEVELAND",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2008-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME42493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.