Individual provider Active NPI

Robert Styles Randolph, M.D.

  • Child & Adolescent Psychiatry Physician
  • Somerset, NJ
National Provider Identifier
1508011552
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MA070184 Issued in NJ
Practice address
8 Sunflower Rd
Somerset, NJ 08873-7153
Phone
(732) 545-6114
Fax
(609) 298-2554
NPI assigned
Nov 18, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X MA070184 NJ Primary

Addresses

Primary practice location

8 Sunflower Rd
Somerset, NJ 08873-7153

Mailing address

8 Sunflower Rd
Somerset, NJ 08873-7153
Phone (732) 545-6114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20220819002698 NJ Practitioner - Psychiatry 7911380167 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA070184NJMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health - Behavioral Health Current Accepting new patients
Rutgers Health - Behavioral Health CurrentSince Aug 1, 2022 Accepting new patients
Rutgers Health - University Behavioral Health Care Past Accepting new patients

Locations

183 S Orange Ave
Newark, NJ 07103
Phone (973) 972-0004

667 Hoes Ln W
Piscataway, NJ 08854
Phone (732) 235-5730

671 Hoes Ln W
Piscataway, NJ 08854
Phone (732) 235-3289

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226966400000",
    "number": "1508011552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 SUNFLOWER RD",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088737153",
            "telephone_number": "732-545-6114",
            "fax_number": "609-298-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 SUNFLOWER RD",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088737153",
            "telephone_number": "732-545-6114",
            "fax_number": "609-298-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "ROBERT",
        "middle_name": "STYLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-18",
        "last_updated": "2008-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "MA070184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

Verify at the official NPI Registry.