Individual provider Active NPI

Charles W Randall, MD

  • Gastroenterology Physician
  • San Antonio, TX
National Provider Identifier
1295814952
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
F53763 Issued in TX
Practice address
8550 Datapoint Dr
Suite 200
San Antonio, TX 78229-3270
Phone
(210) 615-8308
Fax
(210) 615-8313
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X F53763 TX Primary

Addresses

Primary practice location

8550 Datapoint Dr
Suite 200
San Antonio, TX 78229-3270

Mailing address

8550 Datapoint Dr
Suite 200
San Antonio, TX 78229-3270
Phone (210) 615-8308

Other identifiers 1

IdentifierTypeStateIssuer
044080201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120515000326 TX Practitioner - Gastroenterology 6406760479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Texas Medical Branch at Galveston, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gastroenterology Clinic of San Antonio PAGroup PAC ID 7618881681, 8 clinicians

Practice addresses (Care Compare)

8550 Datapoint Dr
Suite 200
San Antonio, TX 78229-3440

8550 Datapoint Dr
Suite Ll100
San Antonio, TX 78229-3436
Phone (210) 615-8308

Hospital & facility affiliations

  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388
  • Baptist Medical Center Hospital, San Antonio, TX, CCN 450058

Merit-based Incentive Payment System (MIPS)

Final score
85.97 of 100Reported as group
Quality
70.36
Promoting interoperability
95
Improvement activities
40
Cost
87.04

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy202
Upper gastrointestinal (GI) endoscopy for acid reflux125

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F53763TXMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Clinic of San Antonio, P.a. Gastroenterology CurrentSince Jul 5, 1990 Accepting new patients

Locations

8550 Datapoint Dr
Ste LL100
San Antonio, TX 78229
Phone (210) 615-8308

8550 Datapoint Dr
Ste 200
San Antonio, TX 78229
Phone (210) 615-8308

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDBEAD

Organizations & group practices 1

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 4

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1295814952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 DATAPOINT DR",
            "address_2": "SUITE 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293270",
            "telephone_number": "210-615-8308",
            "fax_number": "210-615-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 DATAPOINT DR",
            "address_2": "SUITE 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293270",
            "telephone_number": "210-615-8308",
            "fax_number": "210-615-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "CHARLES",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "F53763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044080201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.