MICHAEL RANDOLPH FNP-C
NPI 1417764440
Nurse Practitioner - Family in Maricopa, AZ
About Michael Randolph Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MICHAEL RANDOLPH FNP-C (NPI 1417764440) is an individual family provider in Maricopa, Arizona, licensed in Arizona (270365) and active in the NPI registry since December 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
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
Michael Randolph Fnp-c 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 85139 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Michael Randolph's NPI number?
The NPI number for Michael Randolph is 1417764440. It was assigned to this individual provider in the NPPES registry on December 12, 2024.
Where is Michael Randolph located?
Michael Randolph practices at 20046 N John Wayne Pkwy Ste 102, Maricopa, AZ 85139. The listed phone number is (520) 497-4575.
What is Michael Randolph's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Michael Randolph enrolled in Medicare?
Yes. Michael 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.
What insurance does Michael Randolph accept?
Health plans from Blue Cross Blue Shield of Arizona and UnitedHealthcare list Michael 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 Michael Randolph was last updated on April 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Michael Randolph, FNP-C · NPI 1417764440
Family physician in Maricopa, Arizona. Individual provider, active in the CMS NPPES registry since December 12, 2024.
## Identity
- **NPI:** 1417764440 (Entity type: Individual)
- **Enumerated:** December 12, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 270365 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 20046 N JOHN WAYNE PKWY STE 102, Maricopa, AZ 85139-2977
- **Phone:** (520) 497-4575
## 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 2024
## Record status
- **NPPES last updated:** April 23, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1417764440) · Data from the CMS NPPES public registry.