Blake Randolph, NP-C - Medicare Nurse Practitioner in Waterloo, IA

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Blake Randolph, NP-C is a medicare enrolled "Nurse Practitioner" in Waterloo, Iowa. He graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Iowa Physicians Clinic Medical Foundation and his current practice location is 1631 Logan Ave, Waterloo, Iowa. You can reach out to his office (for appointments etc.) via phone at (319) 833-5381.

Blake Randolph is licensed to practice in Iowa (license number A156287) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1295382786.

Contact Information

Blake Randolph, NP-C
1631 Logan Ave,
Waterloo, IA 50703-1237
(319) 833-5381
Not Available

Map and Direction




Provider's Profile

Full NameBlake Randolph
GenderMale
SpecialityNurse Practitioner
Experience5 Years
Location1631 Logan Ave, Waterloo, Iowa
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Blake Randolph graduated from nursing school in 2019
  NPI Data:
  • NPI Number: 1295382786
  • Provider Enumeration Date: 08/20/2019
  • Last Update Date: 05/01/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 4880926955
  • Enrollment ID: I20191023001966

Medical Identifiers

Medical identifiers for Blake Randolph such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1295382786NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family A156287 (Iowa)Secondary
363L00000XNurse Practitioner A156287 (Iowa)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Allen HospitalWaterloo, IAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Iowa Physicians Clinic Medical Foundation8729992318972

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Blake Randolph allows following entities to bill medicare on his behalf.
Entity NameIowa Physicians Clinic Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1366425274
PECOS PAC ID: 8729992318
Enrollment ID: O20031118000363
Entity NameCedar Valley Medical Specialists Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1497794242
PECOS PAC ID: 1759291487
Enrollment ID: O20031208000462
Entity NameAllen Memorial Hospital Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1891772927
PECOS PAC ID: 4284546045
Enrollment ID: O20031211000480

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Blake Randolph is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Blake Randolph, NP-C
Po Box 2758,
Waterloo, IA 50704-2758

Ph: (319) 235-5390		Blake Randolph, NP-C
1631 Logan Ave,
Waterloo, IA 50703-1237

Ph: (319) 833-5381

Reviews and Comments


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Lisa Lynn Maher, ARNP
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Phone: 319-236-1911    Fax: 319-287-5832
Evans Komen, DNP,PMHNP-BC
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Dianna Kay Magginetti, ARNP
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Ms. Amanda L. Vervaecke, A.R.N.P.
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Practice Location: 1825 Logan Ave, Wound & Ostomy Clinic, Waterloo, IA 50703
Phone: 319-235-3121    Fax: 319-226-2113
Mr. Dieter J Boxmann, ARNP
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Practice Location: 146 W Dale St, Suite 101, Waterloo, IA 50703
Phone: 319-233-3351    Fax: 319-233-3132
Marcia A Rellihan, D.O.
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 3421 W 9th St, Suite G4500, Waterloo, IA 50702
Phone: 319-233-8865    Fax: 319-272-0400

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.