Individual provider Active NPI

Joshua Timothy Randolph, MD

  • Urology Physician
  • Matthews, NC
National Provider Identifier
1255905311
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2026-04683 Issued in NC
Practice address
1100 Healing Way Ste 12
Matthews, NC 28104-5181
Phone
(704) 993-2107
Fax
(704) 993-2115
NPI assigned
May 13, 2021
Last updated
Oct 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2026-04683 NC Primary

Addresses

Primary practice location

1100 Healing Way Ste 12
Matthews, NC 28104-5181

Mailing address

1100 Healing Way Ste 12
Matthews, NC 28104-5181
Phone (704) 993-2107

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241112003185 FL Practitioner - Urology 4981006780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Brody School of Medicine at East Carolina University, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.24 of 100Reported as group
Quality
74.85
Promoting interoperability
100
Improvement activities
40
Cost
72.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME159494FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville CurrentSince Sep 1, 2024 Accepting new patients
Urology Specialists of the Carolinas CurrentSince Oct 1, 2026 Accepting new patients
Urology Specialists of the Carolinas PLLC Urology CurrentSince Oct 1, 2026 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Sep 1, 2024 Accepting new patients

Locations

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1100 Healing Way
Ste 12
Matthews, NC 28104
Phone (704) 993-2107

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791763200000",
    "number": "1255905311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 HEALING WAY STE 12",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281045181",
            "telephone_number": "704-993-2107",
            "fax_number": "704-993-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 HEALING WAY STE 12",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281045181",
            "telephone_number": "704-993-2107",
            "fax_number": "704-993-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "JOSHUA",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-13",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2026-04683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.