John K Randall, RPH, MD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

01042716 Issued in IN

Practice address

124 Sagamore Pkwy W
West Lafayette, IN 47906-1569

Phone

(765) 463-6722

Fax

(765) 463-0905

NPI assigned

Jun 28, 2006

Last updated

Dec 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in IN

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

Micrographic Dermatologic Surgery (MDS)Also: Dermatology

Education

Northeastern Ohio University College of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Randall Dermatology, PCGroup PAC ID 3678675329, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Arnett Hospital Hospital, Lafayette, IN, CCN 150173
• Riverview Health Hospital, Noblesville, IN, CCN 150059
• Ascension St Vincent Kokomo Hospital, Kokomo, IN, CCN 150010
• Indiana University Health White Memorial Hospital Hospital, Monticello, IN, CCN 151312
• Indiana University Health Frankfort Inc Hospital, Frankfort, IN, CCN 151316

Merit-based Incentive Payment System (MIPS)

Final score

88.65 of 100Reported as group

Quality

91.4

Improvement activities

40

Cost

73.63

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Registered Pharmacist

State licenses

Practice roles

Locations

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.

• Randall Dermatology, PC

  • Dermatology Physician
  • West Lafayette Bra, IN
  • NPI 1245340488
  Medicare reassignment Care Compare group NPD Authorized official
• Albert C. Lee, M.D., P.C.

  dba Indiana Neurology Specialty Care

  • Neurology Physician
  • Lafayette, IN
  • NPI 1013047042
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• Indiana University Health Arnett Inc

  dba IU Health Arnett Hospital

  • General Acute Care Hospital
  • Lafayette, IN
  • NPI 1326296211
  Care Compare affiliation
• Indiana University Health Frankfort Inc

  • Critical Access Hospital
  • Frankfort, IN
  • NPI 1346774270
  Care Compare affiliation
• Indiana University Health White Memorial Hospital Inc

  • Critical Access Hospital
  • Monticello, IN
  • NPI 1710983945
  Care Compare affiliation
• Riverview Hospital

  • General Acute Care Hospital
  • Noblesville, IN
  • NPI 1700883717
  Care Compare affiliation
• St. Joseph Hospital & Health Center, Inc.

  dba Ascension St. Vincent Kokomo

  • General Acute Care Hospital
  • Kokomo, IN
  • NPI 1780625442
  Care Compare affiliation

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1326076530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SAGAMORE PKWY W",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061569",
            "telephone_number": "765-463-6722",
            "fax_number": "765-463-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 SAGAMORE PKWY W",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061569",
            "telephone_number": "765-463-6722",
            "fax_number": "765-463-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "JOHN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "RPH, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01042716",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IN",
            "license": "01042716",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "IN",
            "license": "01042716",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSR",
            "identifier": "01042716B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000092649",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200207110A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "01042716",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100415730A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Queen
• Benjamin M Rachwal, R.PH.
• Megan Renee Rahn, RN, MSN
• Allison Rainey
• Esteban F Ramirez, DO
• Avantika Aghi Rastogi
• James O Reeder, MD
• Mark S Reef, MSN, RN, PMHCNS-BC
• Rehema Home Health, LLC
• Diane Crowley Reis, M.D.

• MOHS-Micrographic Surgery Physician in West Lafayette, IN
• Providers in West Lafayette, IN by specialty
• MOHS-Micrographic Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.