Blake Randolph, NP-C is a medicare enrolled "Nurse Practitioner" in Reinbeck, Iowa. He graduated from nursing school in 2019 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. His current practice location is
604 West St, Reinbeck, Iowa. You can reach out to his office (for appointments etc.) via phone at
(319) 575-0180.
Blake Randolph is licensed to practice in Iowa (license number A156287) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1295382786.
Provider's Profile
| Full Name | Blake Randolph |
|---|
| Gender | Male |
|---|
| Speciality | Nurse Practitioner |
|---|
| Experience | 6 Years |
|---|
| Location | 604 West St, Reinbeck, Iowa |
|---|
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for 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: 08/21/2025
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.
| Identifier | Type | State | Issuer |
|---|
| 1295382786 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | A156287 (Iowa) | Secondary |
| 363L00000X | Nurse Practitioner | A156287 (Iowa) | 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. Blake Randolph allows following entities to bill medicare on his behalf.
| Entity Name | Mcfarland Clinic Pc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1639135643
PECOS PAC ID: 1254244239
Enrollment ID: O20031106000338 |
|---|
| Entity Name | Iowa Physicians Clinic Medical Foundation |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1366425274
PECOS PAC ID: 8729992318
Enrollment ID: O20031118000363 |
|---|
| Entity Name | Allen Memorial Hospital Corporation |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI 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 Address | Practice Location Address |
|---|
Blake Randolph, NP-C
604 West St,
Reinbeck, IA 50669-1353
Ph: (319) 575-0180 | Blake Randolph, NP-C
604 West St,
Reinbeck, IA 50669-1353
Ph: (319) 575-0180 |
Reviews and Comments