Dr Mary Kay Randolph, MD is a medicare enrolled "Family Medicine" physician in Polo, Missouri. She went to University Of Kansas School Of Med (kc/wich/sal) and graduated in 1992 and has 33 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Midwest Division - Lrhc Llc and her current practice location is
36584 W 220th St, Polo, Missouri. You can reach out to her office (for appointments etc.) via phone at
(816) 809-7730.
Dr Mary Kay Randolph is licensed to practice in Missouri (license number 101542) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1841203023.
Physician's Profile
| Full Name | Dr Mary Kay Randolph |
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| Gender | Female |
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| Speciality | Family Practice |
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| Experience | 33 Years |
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| Location | 36584 W 220th St, Polo, Missouri |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Mary Kay Randolph attended and graduated from University Of Kansas School Of Med (kc/wich/sal) in 1992
NPI Data:
- NPI Number: 1841203023
- Provider Enumeration Date: 08/15/2006
- Last Update Date: 09/19/2023
Medicare PECOS Information:
- PECOS PAC ID: 4385714534
- Enrollment ID: I20230613003221
Medical Identifiers
Medical identifiers for Dr Mary Kay Randolph such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1841203023 | NPI | - | NPPES |
| 068002402 | Other | KS | MEDICARE PTAN |
| 100175570C | Medicaid | KS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 036-121726 (Illinois) | Secondary |
| 207Q00000X | Family Medicine | 04-25049 (Kansas) | Secondary |
| 207Q00000X | Family Medicine | 101542 (Missouri) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Midwest Division - Lrhc Llc | 0941119150 | 41 |
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. Dr Mary Kay 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 Address | Practice Location Address |
|---|
Dr Mary Kay Randolph, MD
36584 W 220th St,
Polo, MO 64671-8669
Ph: (816) 809-7730 | Dr Mary Kay Randolph, MD
36584 W 220th St,
Polo, MO 64671-8669
Ph: (816) 809-7730 |
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