Dr Mildred B Randolph, DO in Mount Laurel, NJ

Dr Mildred B Randolph, DO is a medicare enrolled "Family Medicine" physician in Mount Laurel, New Jersey. Her current practice location is 100 Century Pkwy Ste 140, Mount Laurel, New Jersey. You can reach out to her office (for appointments etc.) via phone at (856) 380-2400.

Dr Mildred B Randolph is licensed to practice in New Jersey (license number 25MB11608200) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1811511033.

Contact Information

	Dr Mildred B Randolph, DO
	100 Century Pkwy Ste 140, Mount Laurel, NJ 08054-1149
	(856) 380-2400
	(856) 234-7870

Map and Direction

Physician's Profile

Full Name	Dr Mildred B Randolph
Gender	Female
Speciality	Family Medicine
Location	100 Century Pkwy Ste 140, Mount Laurel, New Jersey
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1811511033
Provider Enumeration Date: 06/03/2020
Last Update Date: 10/16/2023

Medicare PECOS Information:

PECOS PAC ID: 6204204951
Enrollment ID: I20221130001311

Medical Identifiers

Medical identifiers for Dr Mildred B Randolph such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1811511033	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	25MB11608200 (New Jersey)	Primary

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. Dr Mildred B Randolph allows following entities to bill medicare on her behalf.

Entity Name	Virtua Medical Group, Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1649226515 PECOS PAC ID: 9830222397 Enrollment ID: O20100804000338

Entity Name	Patient First Maryland Physicians Group, P.c..
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1982733564 PECOS PAC ID: 9335391978 Enrollment ID: O20150605001407

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 Mildred B 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 Mildred B Randolph, DO 100 Century Pkwy Ste 140, Mount Laurel, NJ 08054-1149 Ph: (856) 380-2400	Dr Mildred B Randolph, DO 100 Century Pkwy Ste 140, Mount Laurel, NJ 08054-1149 Ph: (856) 380-2400

Reviews and Comments

Family Medicine Doctors in Mount Laurel, NJ

Dr. Martin Polnerow, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: Ramblewood Center, 1155 Rt.73 Ste. J, Mount Laurel, NJ 08054 Phone: 856-235-2505 Fax: 856-235-6425
Dr. Frank P Pettinelli, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 3814 Church Rd, Mount Laurel, NJ 08054 Phone: 856-231-9792 Fax: 856-231-9862
Jennifer Sepede, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 Century Pkwy Ste 140, Mount Laurel, NJ 08054 Phone: 856-380-2400 Fax: 856-234-7870
Thomas Y Lee, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4510 Church Rd, Mount Laurel, NJ 08054 Phone: 856-439-0060 Fax: 856-452-0344
Samantha M. Plasner, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 Century Pkwy Ste 140, Mount Laurel, NJ 08054 Phone: 856-380-2400 Fax: 856-234-7870
Gary I Shapiro, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 204 Ark Rd, Suite 103, Mount Laurel, NJ 08054 Phone: 856-778-4756 Fax: 856-778-1742
Emily A. Burns, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 3906 Church Rd, Mount Laurel, NJ 08054 Phone: 856-596-1600

Dr Mildred B Randolph, DO - Medicare Family Medicine in Mount Laurel, NJ