MACKENZIE RANDOLPH
NPI 1073482014
Nurse Practitioner - Family in Dallas, TX
About Mackenzie Randolph NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MACKENZIE RANDOLPH (NPI 1073482014) is an individual family provider in Dallas, Texas, licensed in Texas (1231411) and active in the NPI registry since October 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mackenzie Randolph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Mackenzie Randolph reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Round Rock, TX 78664
- Reassigned Medicare billing, Texas enrollment
- 493 clinicians in this Medicare group
Spring, TX 77373
- Reassigned Medicare billing, Texas enrollment
- 238 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 75204 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mackenzie Randolph's NPI number?
The NPI number for Mackenzie Randolph is 1073482014. It was assigned to this individual provider in the NPPES registry on October 29, 2025.
Where is Mackenzie Randolph located?
Mackenzie Randolph practices at 3133 E Lemmon Ave, Dallas, TX 75204. The listed phone number is (214) 599-2108.
What is Mackenzie Randolph's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Mackenzie Randolph enrolled in Medicare?
Yes. Mackenzie Randolph is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Mackenzie Randolph's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mackenzie Randolph reassigns Medicare benefits to 2 organizations: Minuteclinic Diagnostic Of Texas PLLC (Round Rock, TX) and Minuteclinic Primary Care Texas PLLC (Spring, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mackenzie Randolph's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mackenzie Randolph accept?
Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Mackenzie Randolph as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mackenzie Randolph was last updated on June 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mackenzie Randolph · NPI 1073482014
Family physician in Dallas, Texas. Individual provider, active in the CMS NPPES registry since October 29, 2025.
## Identity
- **NPI:** 1073482014 (Entity type: Individual)
- **Enumerated:** October 29, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 1231411 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 3133 E LEMMON AVE, Dallas, TX 75204-1411
- **Phone:** (214) 599-2108
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Minuteclinic Diagnostic Of Texas PLLC (NPI 1609076330, Round Rock, TX); Minuteclinic Primary Care Texas PLLC (NPI 1710794292, Spring, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** June 3, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1073482014) · Data from the CMS NPPES public registry.