Individual provider Active NPI

Jess T. Randall, MD

  • Interventional Cardiology Physician
  • Lexington, KY
National Provider Identifier
1730447525
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
35.151910 Issued in OH
Practice address
740 S Limestone Ste L203
Lexington, KY 40536-0001
Phone
(859) 323-6754
Fax
(859) 323-3499
NPI assigned
Apr 30, 2012
Reactivated
Oct 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 306608 NY
Interventional Cardiology Physician 207RI0011X 35.151910 OH Primary
Pediatric Cardiology Physician 2080P0202X 59406 KY

Addresses

Primary practice location

740 S Limestone Ste L203
Lexington, KY 40536-0001

Mailing address

319 S. Manning Blvd
Suite 203
Albany, NY 12208
Phone (518) 489-3292

Other practice location 1

319 S. Manning Blvd
Suite 203
Albany, NY 12208
Phone (518) 489-3292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, KY, OH3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210114000039 NY Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 0648585877 Reassigns benefits to 2 organizations
I20240723003296 KY Practitioner - Pediatric Medicine 0648585877 Reassigns benefits to 2 organizations
I20250424003226 OH Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 0648585877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

740 S Limestone St
Lexington, KY 40508-1683
Phone (859) 257-8562

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.151910OHMDInterventional Cardiology Physician
59406KYMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Pediatric Cardiology CurrentSince Feb 1, 2022 Accepting new patients
Albany Medical College Current Accepting new patients
Capital District Pediatric Cardiology Associates PC Pediatric Cardiology CurrentSince Jul 15, 2020 Accepting new patients
Children's Hospital Medical Center CurrentSince Mar 13, 2025 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Feb 1, 2022 Accepting new patients
University of Kentucky CurrentSince Jun 20, 2024 Accepting new patients
Albany Medical College CurrentSince Feb 1, 2022 Accepting new patients
Kentucky Medical Services Foundation, Inc Family Medicine CurrentSince Jun 20, 2024 Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

319 S Manning Blvd
Ste 203
Albany, NY 12208
Phone (518) 489-3292

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

22 New Scotland Ave
Albany, NY 12208
Phone (518) 262-5333

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

Organizations & group practices 9

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": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1730447525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 S. MANNING BLVD",
            "address_2": "SUITE 203",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208",
            "telephone_number": "518-489-3292",
            "fax_number": "518-453-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE STE L203",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-323-6754",
            "fax_number": "859-323-3499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "319 S. Manning Blvd",
            "address_2": "Suite 203",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "12208",
            "country_code": "US",
            "telephone_number": "518-489-3292",
            "fax_number": "518-453-6786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "JESS",
        "middle_name": "T.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-30",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "deactivation_date": "2020-09-30",
        "reactivation_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "306608",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OH",
            "license": "35.151910",
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "KY",
            "license": "59406",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.