DERRICK RANDDOLF MD
NPI 1104205343
Family Medicine in Odessa, TX
About Derrick Randdolf Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DERRICK RANDDOLF MD (NPI 1104205343) is an individual family medicine provider in Odessa, Texas, licensed in Texas (R4622) and active in the NPI registry since May 2015. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Central Texas, and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Derrick Randdolf Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
14Medicare enrollment records show Derrick Randdolf reassigns Medicare billing to 14 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Odessa, TX 79761
- Reassigned Medicare billing, Texas enrollment
- 80 clinicians in this Medicare group
Seminole, TX 79360
- Reassigned Medicare billing, Texas enrollment
- 115 clinicians in this Medicare group
Lubbock, TX 79401
- Reassigned Medicare billing, Texas enrollment
- 1,439 clinicians in this Medicare group
Lubbock, TX 79401
- Reassigned Medicare billing, Texas enrollment
- Medicare enrollment name: Concord Medical Group PLLC
- 1,338 clinicians in this Medicare group
Plainview, TX 79072
- Reassigned Medicare billing, Texas enrollment
- 217 clinicians in this Medicare group
San Antonio, TX 78257
- Reassigned Medicare billing, Texas enrollment
- 4 clinicians in this Medicare group
San Antonio, TX 78257
- Reassigned Medicare billing, Texas enrollment
Killeen, TX 76549
- Reassigned Medicare billing, Texas enrollment
- 214 clinicians in this Medicare group
Killeen, TX 76549
- Reassigned Medicare billing, Texas enrollment
- 387 clinicians in this Medicare group
San Antonio, TX 78249
- Reassigned Medicare billing, Texas enrollment
- 379 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.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Adventhealth Central Texas
Acute Care Hospitals · Killeen, TXScenic Mountain Medical Center, A Steward Family H
Acute Care Hospitals · Big Spring, TXBaptist Neighborhood Hospital Thousand Oaks
Acute Care Hospitals · San Antonio, TXPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 79763 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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.
ODESSA, TX 79763
ODESSA, TX 79763
ODESSA, TX 79763
ODESSA, TX 79763
ODESSA, TX 79763
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 Derrick Randdolf's NPI number?
The NPI number for Derrick Randdolf is 1104205343. It was assigned to this individual provider in the NPPES registry on May 20, 2015.
Where is Derrick Randdolf located?
Derrick Randdolf practices at 701 W 5th St, Odessa, TX 79763. The listed phone number is (432) 703-5375.
What is Derrick Randdolf's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Derrick Randdolf enrolled in Medicare?
Yes. Derrick Randdolf is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Derrick Randdolf's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Derrick Randdolf reassigns Medicare benefits to 14 organizations: Odessa Physician Associates, PLLC (Odessa, TX), Seminole Hospital District Of Gaines County Texas (Seminole, TX), Concord Medical Group Of Texas PLLC (Lubbock, TX), Concord Medical Group Of Texas PLLC (Lubbock, TX), Hospitalist Medicine Physicians Of Texas - Houston, PLLC (Plainview, TX) and 9 more organizations, listed in the Medicare section above. 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 Derrick Randdolf's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Derrick Randdolf accept?
Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Oscar Health, Oscar Insurance Company and Sendero Health Plans, Local Nonprofit list Derrick Randdolf 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.
Is Derrick Randdolf affiliated with any hospitals?
According to CMS data, Derrick Randdolf is affiliated with Adventhealth Central Texas, Scenic Mountain Medical Center, A Steward Family H and Baptist Neighborhood Hospital Thousand Oaks.
When was this NPI record last updated?
The NPPES record for Derrick Randdolf was last updated on February 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.
# Derrick Randdolf, MD · NPI 1104205343
Family Medicine physician in Odessa, Texas. Individual provider, active in the CMS NPPES registry since May 20, 2015.
## Identity
- **NPI:** 1104205343 (Entity type: Individual)
- **Enumerated:** May 20, 2015
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** R4622 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 701 W 5TH ST, Odessa, TX 79763-4206
- **Phone:** (432) 703-5375 · **Fax:** (432) 703-5238
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 14 organizations under Medicare reassignment (form CMS-855R): Odessa Physician Associates, PLLC (NPI 1457398364, Odessa, TX); Seminole Hospital District Of Gaines County Texas (NPI 1821025990, Seminole, TX); Concord Medical Group Of Texas PLLC (NPI 1750790762, Lubbock, TX); Concord Medical Group Of Texas PLLC (NPI 1750790762, Lubbock, TX); Hospitalist Medicine Physicians Of Texas - Houston, PLLC (NPI 1760028740, Plainview, TX); and 9 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** February 26, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1104205343) · Data from the CMS NPPES public registry.