CLEVELAND W RANDOLPH JR. M.D.
NPI 1124014287
Specialist in Jacksonville Beach, FL
About Cleveland W Randolph Jr. M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CLEVELAND W RANDOLPH JR. M.D. (NPI 1124014287) is an individual specialist in Jacksonville Beach, Florida, licensed in Florida (ME42493) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and is a graduate of Other (1982).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 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
Cleveland W Randolph Jr. M.d. 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 Reassignment
Medicare enrollment records show Cleveland Randolph reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Jacksonville Beach, FL 32250
- Reassigned Medicare billing, Florida enrollment
- 8 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
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 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Baptist Health Medical Center - Jacksonville
Acute Care Hospitals · Jacksonville, FLBaptist Medical Center Beaches
Acute Care Hospitals · Jacksonville Beach, FLOther Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
JACKSONVILLE, FL 32250
JACKSONVILLE BEACH, FL 32250
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 Cleveland Randolph's NPI number?
The NPI number for Cleveland Randolph is 1124014287. It was assigned to this individual provider in the NPPES registry on September 23, 2005.
Where is Cleveland Randolph located?
Cleveland Randolph practices at 1891 Beach Blvd Ste. 200, Jacksonville Beach, FL 32250. The listed phone number is (904) 249-3743.
What is Cleveland Randolph's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Cleveland Randolph enrolled in Medicare?
Yes. Cleveland Randolph 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 organization bills Medicare for Cleveland Randolph's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Cleveland Randolph reassigns Medicare benefits to Cleveland W Randolph, Jr, MD, PA (Jacksonville Beach, FL). The 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 Cleveland Randolph's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Cleveland Randolph accept?
Health plans from AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Cleveland 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.
Is Cleveland Randolph affiliated with any hospitals?
According to CMS data, Cleveland Randolph is affiliated with Baptist Health Medical Center - Jacksonville and Baptist Medical Center Beaches.
When was this NPI record last updated?
The NPPES record for Cleveland Randolph was last updated on August 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.
# Cleveland W Randolph Jr., M.D. · NPI 1124014287
Specialist provider in Jacksonville Beach, Florida. Individual provider, active in the CMS NPPES registry since September 23, 2005.
## Identity
- **NPI:** 1124014287 (Entity type: Individual)
- **Enumerated:** September 23, 2005
- **Primary specialty:** Specialist · taxonomy 174400000X
- **State license:** ME42493 (Florida)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1891 BEACH BLVD, STE. 200, Jacksonville Beach, FL 32250-2644
- **Phone:** (904) 249-3743 · **Fax:** (904) 249-2047
## 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:** Cleveland W Randolph, Jr, MD, PA (NPI 1497808182, Jacksonville Beach, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1982
## Record status
- **NPPES last updated:** August 18, 2008
- **Other identifiers:** Medicare UPIN D52739 (FL); Medicare PIN 15788Y (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1124014287) · Data from the CMS NPPES public registry.