NPIMap

Organization Active NPI

Randolph Medical Associates, PC

  • Internal Medicine Physician
  • Randolph, MA
National Provider Identifier
1790984268
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
76450 Issued in MA
Legal business name
RANDOLPH MEDICAL ASSOCIATES, PC
Practice address
32 So Main St
Suite 200
Randolph, MA 02368
Phone
(781) 986-1368
Fax
(781) 986-1749
NPI assigned
Jul 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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

Authorized official

Name
Maria Ana Rodrigues, MDNPI 1750350708
Title
Owner
Phone
(781) 986-1368

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 76450 MA Primary

Addresses

Primary practice location

32 So Main St
Suite 200
Randolph, MA 02368

Mailing address

32 So Main St
Ste 200
Randolph, MA 02368
Phone (781) 986-1368

Other identifiers 1

IdentifierTypeStateIssuer
9724940MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050617000036 MA Part B Supplier - Clinic/Group Practice 6406890797 Receives reassigned benefits from 1 practitioner
Practice locations: Randolph, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1790984268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 SO MAIN ST",
            "address_2": "STE 200",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "02368",
            "telephone_number": "781-986-1368",
            "fax_number": "781-986-1749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 SO MAIN ST",
            "address_2": "SUITE 200",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "02368",
            "telephone_number": "781-986-1368",
            "fax_number": "781-986-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "RODRIGUES",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "ANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-986-1368",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "76450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9724940",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; 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.