JESSICA RANDOLPH LPC, PA
NPI 1174842215
Physician Assistant - Medical in Tahlequah, OK
About Jessica Randolph Lpc, Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JESSICA RANDOLPH LPC, PA (NPI 1174842215) is an individual medical provider in Tahlequah, Oklahoma, licensed in Oklahoma (3205) and active in the NPI registry since May 2010. She is enrolled in Medicare PECOS, is affiliated with Cherokee Nation W W Hastings Indian Hospital, and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jessica Randolph Lpc, Pa 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.
Areas of Expertise CMS Part B claims 2
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
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Cherokee Nation W W Hastings Indian Hospital
Acute Care Hospitals · Tahlequah, OKMedicare 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.
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.
TAHLEQUAH, OK 74464
TAHLEQUAH, OK 74464
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 Jessica Randolph's NPI number?
The NPI number for Jessica Randolph is 1174842215. It was assigned to this individual provider in the NPPES registry on May 28, 2010.
Where is Jessica Randolph located?
Jessica Randolph practices at 100 S Bliss Ave, Tahlequah, OK 74464. The listed phone number is (918) 458-3100.
What is Jessica Randolph's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Jessica Randolph enrolled in Medicare?
Yes. Jessica 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.
Is Jessica Randolph affiliated with any hospitals?
According to CMS data, Jessica Randolph is affiliated with Cherokee Nation W W Hastings Indian Hospital.
When was this NPI record last updated?
The NPPES record for Jessica Randolph was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Jessica Randolph, LPC, PA · NPI 1174842215
Medical physician in Tahlequah, Oklahoma. Individual provider, active in the CMS NPPES registry since May 28, 2010.
## Identity
- **NPI:** 1174842215 (Entity type: Individual)
- **Enumerated:** May 28, 2010
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** 3205 (Oklahoma)
- **Sole proprietor:** No
## Practice location
- **Address:** 100 S BLISS AVE, Tahlequah, OK 74464-2512
- **Phone:** (918) 458-3100
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** May 5, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1174842215) · Data from the CMS NPPES public registry.