Cynthia Randolph, P.A.C.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C0002701 Issued in MD

Practice address

12547 Ocean Gateway
Ocean City, MD 21842-9341

Phone

(410) 213-0119

Fax

(410) 213-2875

NPI assigned

Nov 24, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acute Injury and Illness Centers LLCGroup PAC ID 3870687536, 9 clinicians

Access Primary Care LLCGroup PAC ID 0345479986, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019
• Atlantic General Hospital Hospital, Berlin, MD, CCN 210061

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Access Primary Care LLC

  • Primary Care Clinic/Center
  • Ocean City, MD
  • NPI 1033550496
  Medicare reassignment Care Compare group
• Acute Injury and Illness Centers LLC

  dba West Ocean City Injury & Illness Center

  • Urgent Care Clinic/Center
  • Ocean City, MD
  • NPI 1548330343
  Medicare reassignment Care Compare group
• 75TH Street Injury & Illness Center LLC

  • Emergency Medicine Physician
  • Ocean City, MD
  • NPI 1245740109
  Authorized official Same address or phone
• Pinion Road Clinic

  • Internal Medicine Physician
  • Elko, NV
  • NPI 1275703373
  NPD (past)

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

• Tidalhealth Atlantic, Inc

  dba Atlantic General Hospital Corp

  • General Acute Care Hospital
  • Berlin, MD
  • NPI 1053309120
  Care Compare affiliation
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1326113242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12547 OCEAN GATEWAY",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "218429341",
            "telephone_number": "410-213-0119",
            "fax_number": "410-213-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12547 OCEAN GATEWAY",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "218429341",
            "telephone_number": "410-213-0119",
            "fax_number": "410-213-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "CYNTHIA",
        "name_prefix": "Ms.",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0002701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P.A.C. CERTIFICATION",
            "identifier": "1032642",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P.A. LICENSE",
            "identifier": "C5-0000497",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P.A, LICENSE",
            "identifier": "C0002701",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESCRIBE NARCOTICS",
            "identifier": "PA0202",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE TO PRESCRIBE CONT",
            "identifier": "PA55377",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vaeda Pontosky
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• Stephanie Jo Price-Harris, O.D.
• Progressive Physical Therapy, LLC
• Michael Quillin
• Vipa Ravyn, RPH,PHD
• Rite Aid of Maryland Inc (Rite Aid Pharmacy 03835)
• Rite Aid of Maryland Inc (Rite Aid Pharmacy 04005)
• Geoffrey Robbins, D.D.S.
• Harvey David Rosenberg

• Medical Physician Assistant in Ocean City, MD
• Providers in Ocean City, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.