Pamela Dawn Randolph Jackson, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

DC 19357 Issued in DC

Practice address

110 Irving St NW
Washington, DC 20010

Phone

(800) 353-0788

Fax

(804) 355-6031

NPI assigned

Jul 17, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

Radiation Oncology

Education

East Tennessee State University Quillen College of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medstar Washington Hospital Center Hospital, Washington, DC, CCN 090011

Merit-based Incentive Payment System (MIPS)

Final score

82.34 of 100Reported as group

Quality

67.9

Promoting interoperability

100

Improvement activities

40

Cost

69.47

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Medstar Washington Hospital Center

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1548378235

  Corporate Director

  CMS ownership
• Washington Hospital Center Corporation

  • Psychiatric Hospital
  • Washington, DC
  • NPI 1881701217

  Corporate Director

  CMS ownership

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.

• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187

  DC

  Medicare reassignment Care Compare group NPD
• Medstar Medical Group II LLC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1376887844
  NPD

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

• Medstar Washington Hospital Center

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1548378235
  Care Compare affiliation

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324598400000",
    "number": "1801813407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12605 WILLOW MARSH LANE",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "20720",
            "telephone_number": "301-262-1528",
            "fax_number": "804-355-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20010",
            "telephone_number": "800-353-0788",
            "fax_number": "804-355-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH JACKSON",
        "first_name": "PAMELA",
        "middle_name": "DAWN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "DC",
            "license": "DC 19357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010150469",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pearl Christine Randall
• Sierra Randall
• Todd Randall, PSY.D.
• Adrienne Randle, LPC
• Anthony James Randleman
• Aisha Randolph
• Bria Randolph, LGSW
• Corlis Yvonne Randolph, PH.D.
• Darlene C Randolph
• Daynica Briona Randolph

• Radiation Oncology Physician in Washington, DC
• Providers in Washington, DC by specialty
• Radiation Oncology Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.