Organization Active NPI

Randall P. Riche Mdpa

  • Endocrinology, Diabetes & Metabolism Physician
  • Pensacola, FL
National Provider Identifier
1477510402
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
RANDALL P. RICHE MDPA
Practice address
4700 Bayou Blvd Ste 1B
Pensacola, FL 32503-2670
Phone
(850) 432-9698
Fax
(850) 432-9453
NPI assigned
Apr 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Authorized official

Name
Dr. Randall Paul Riche, MDNPI 1821099516
Title
President
Phone
(850) 432-9698

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME59729 FL
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

4700 Bayou Blvd Ste 1B
Pensacola, FL 32503-2670

Mailing address

4700 Bayou Blvd Ste 1B
Pensacola, FL 32503-2670
Phone (850) 478-1312

Other identifiers 1

IdentifierTypeStateIssuer
259118900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040422001760 FL Part B Supplier - Clinic/Group Practice 0244226397 Receives reassigned benefits from 1 practitioner
Practice locations: Pensacola, FL

National Provider Directory

National Provider Directory

Locations

1717 N E St
Ste 438
Pensacola, FL 32501
Phone (850) 432-9698

4700 Bayou Blvd
Ste 1B
Pensacola, FL 32503
Phone (850) 432-9698

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1477510402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 BAYOU BLVD STE 1B",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032670",
            "telephone_number": "850-478-1312",
            "fax_number": "850-432-9453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 BAYOU BLVD STE 1B",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032670",
            "telephone_number": "850-432-9698",
            "fax_number": "850-432-9453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL P. RICHE MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "RICHE",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-432-9698",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME59729",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259118900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.