Mildred B. Randolph, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MB11608200 Issued in NJ

Practice address

405 Hurffville Crosskeys Rd Ste 101
Sewell, NJ 08080-9340

Phone

(856) 218-0300

Fax

(856) 589-5082

NPI assigned

Jun 3, 2020

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

Electronic endpoints 6

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

Specialty

Family Practice

Education

Lake Erie College of Osteopathic Medicine, Erie, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayada at Inspira, Home Health and Hospice Home health agency, Millville, NJ, CCN 317089
• West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: njexchange@patientfirstclinics.com

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.

• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515
  Medicare reassignment Care Compare group NPD
• Patient First Maryland Physician's Group PC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1982733564

  NJ

  Medicare reassignment NPD
• Patients First Maryland Physicians Group P C

  • Family Medicine Physician
  • Cherry Hill, NJ
  • NPI 1114477270
  NPD
• Virtua Medical Group, PA

  dba Virtua Reconstructive Orthopedics - Delran

  • Orthopaedic Surgery Physician
  • Delran, NJ
  • NPI 1841087988
  NPD
• Virtua Medical Group, PA

  • Urgent Care Clinic/Center
  • Mount Holly, NJ
  • NPI 1851841696
  NPD

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

• Tri-County Home and Hospice Care,LLC

  dba BAYADA at Inspira, Home Health and Hospice

  • Home Health Agency
  • West Deptford, NJ
  • NPI 1629431481
  Care Compare affiliation
• Tri-County Home and Hospice Care,LLC

  dba BAYADA at Inspira, Home Health and Hospice

  • Home Health Agency
  • Millville, NJ
  • NPI 1710340575
  Care Compare affiliation
• Virtua - West Jersey Health System, Inc.

  • General Acute Care Hospital
  • Voorhees, NJ
  • NPI 1528064409
  Care Compare affiliation

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1811511033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 HURFFVILLE CROSSKEYS RD STE 101",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080809340",
            "telephone_number": "856-218-0300",
            "fax_number": "856-589-5082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 HURFFVILLE CROSSKEYS RD STE 101",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080809340",
            "telephone_number": "856-218-0300",
            "fax_number": "856-589-5082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Century Pkwy Ste 140",
            "address_purpose": "LOCATION",
            "city": "Mount Laurel",
            "state": "NJ",
            "postal_code": "080541149",
            "country_code": "US",
            "telephone_number": "856-380-2400",
            "fax_number": "856-234-7870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "854 S White Horse Pike Unit 4",
            "address_purpose": "LOCATION",
            "city": "Hammonton",
            "state": "NJ",
            "postal_code": "080372033",
            "country_code": "US",
            "telephone_number": "609-704-0185",
            "fax_number": "609-704-0195",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1474 Tanyard Road",
            "address_2": "Suite D100",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "08080",
            "country_code": "US",
            "telephone_number": "856-566-7045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "42 E Laurel Rd Ste 2100A",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "NJ",
            "postal_code": "080841354",
            "country_code": "US",
            "telephone_number": "856-566-6477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "MILDRED",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB11608200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NJExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "630 Mantua Pike",
            "city": "Woodbury",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080963233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrandolph167011@directvirtua.org",
            "affiliation": "N",
            "address_1": "42 E Laurel Rd Ste 2100A",
            "city": "Stratford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080841354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrandolph167011@directvirtua.org",
            "affiliation": "N",
            "address_1": "1474 Tanyard Road",
            "address_2": "Suite D100",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "08080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrandolph167011@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Century Pkwy Ste 140",
            "city": "Mount Laurel",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080541149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrandolph167011@directvirtua.org",
            "affiliation": "N",
            "address_1": "854 S White Horse Pike Unit 4",
            "city": "Hammonton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080372033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrandolph167011@directvirtua.org",
            "affiliation": "N",
            "address_1": "405 Hurffville Crosskeys Rd Ste 101",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080809340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Rader, MSN, FNP-C
• Shakera Rainner, LCSW
• Altamash Raja, D.O.
• Srushti Raja, DO
• Karina Rachel Randazzo, M.S. OTR/L
• Joseph N. Ranieri, DO
• Deborah Rapone, RPH
• Christina Patricia Raucci
• Nutan K Ravani, MSW, LCSW
• Reconstructive Orthopedics, P.a.

• Family Medicine Physician in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.