NPIMap

Individual provider Active NPI

Michael Anthony Randolph, M.D.

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1215095203
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D43680 Issued in MD
Practice address
200 E 33Rd St
Suite 136
Baltimore, MD 21218-3322
Phone
(410) 554-6489
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D43680 MD Primary

Addresses

Primary practice location

200 E 33Rd St
Suite 136
Baltimore, MD 21218-3322

Mailing address

1104 Valewood Rd
Towson, MD 21286-1653
Phone (410) 337-7205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090630000490 MD Practitioner - Internal Medicine 8123195740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
George Washington University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

200 E 33Rd St
Suite 136
Baltimore, MD 21218-3384
Phone (410) 554-6489

Hospital & facility affiliations

  • Medstar Health Home Care Home health agency, Baltimore, MD, CCN 217068
  • Bayada Home Health Care, Inc. Home health agency, Towson, MD, CCN 217101
  • Adoration Home Health Baltimore Home health agency, Baltimore, MD, CCN 217134
  • Medstar Union Memorial Hospital Hospital, Baltimore, MD, CCN 210024
  • Medstar Franklin Square Medical Center Hospital, Rosedale, MD, CCN 210015
  • Medstar Good Samaritan Hospital Hospital, Baltimore, MD, CCN 210056

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D43680MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael a. Randolph, MD PC Internal Medicine CurrentSince Jul 2, 2002 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

200 E 33rd St
Ste 136
Baltimore, MD 21218
Phone (410) 261-8997

Interoperability endpoints

  • Direct secure messaging: michael.randolph@direct.michaelrandolphmd.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Medstar Union Memorial HospitalBaltimore, MD, CCN 210024 Hospital Corporate Director Nov 1, 2014
Medstar Good Samaritan HospitalBaltimore, MD, CCN 210056 Hospital Corporate Director Nov 1, 2014

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1215095203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 VALEWOOD RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212861653",
            "telephone_number": "410-337-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 33RD ST",
            "address_2": "SUITE 136",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183322",
            "telephone_number": "410-554-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D43680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.