Edward L Randerson, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

72013 Issued in WI

Practice address

925 N 87TH St
Milwaukee, WI 53226-4812

Phone

(414) 955-2020

Fax

(414) 955-6300

NPI assigned

Apr 10, 2017

Sex

Male

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 WI

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

Ophthalmology

Education

Medical College of Wisconsin, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Froedtert Andthe Medical College of Wisconsin Community Physicians IncGroup PAC ID 3678760063, 1,265 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177
• Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eranderson38889@direct.chw.org
• Direct secure messaging: erandersonmd254011@direct.froedtert.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.

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment Care Compare group NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment Care Compare group NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• Children'S Specialty Group, Inc.

  • Pediatrics Physician
  • Milwaukee, WI
  • NPI 1942970405
  NPD (past)

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

• Froedtert Memorial Lutheran Hospital, Inc.

  dba CDI-Froedtert Memorial Lutheran Hospital

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1255334173
  Care Compare affiliation
• Froedtert South, Inc.

  • General Acute Care Hospital
  • Pleasant Prairie, WI
  • NPI 1003831132
  Care Compare affiliation

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1932632684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 N 87TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264812",
            "telephone_number": "414-955-2020",
            "fax_number": "414-955-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 N 87TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264812",
            "telephone_number": "414-955-2020",
            "fax_number": "414-955-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDERSON",
        "first_name": "EDWARD",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "72013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932632684",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beverly Jean Rand, RN
• Letitia Rand, SACIT
• Scott D Rand, MD
• Melinda M Randa, LCSW
• Tarah Randazzo, LPC
• Amber M Randle, RDH
• Terrisha Lee Randle, LPN
• Robert Randolph
• Randy R Ciepluch (Family Dental Center)
• Randy R Ciepluch DDS

• Ophthalmology Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.