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MS. KIMBERLY T RANDOLPH ARNP-C
NPI 1457788671
Nurse Practitioner - Adult Health in Tampa, FL

Active since October 02, 2013PECOS EnrolledAccepts Medicare Assignment
13047 W LINEBAUGH AVE STE 102, TAMPA, FL 33626(813) 475-6542 Get Directions Write a Review

NPPES record last updated: August 19, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 19, 2021, Mar 16, 2020 (2 updates tracked since 2020).

About Ms. Kimberly T Randolph Arnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KIMBERLY T RANDOLPH ARNP-C (NPI 1457788671) is an individual adult health provider in Tampa, Florida, licensed in Florida (ARNP9318390) and active in the NPI registry since October 2013. She is enrolled in Medicare PECOS, maintains a secondary practice location in Tampa, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1457788671
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameMS. KIMBERLY T RANDOLPHCredential: ARNP-C
Location Address13047 W LINEBAUGH AVE STE 102Tampa, FL 33626-4487
Mailing Address13047 W Linebaugh Ave Ste 102Tampa, FL 33626-4487 · (813) 475-6542 · Fax (813) 475-6874
Phone(813) 475-6542
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateOctober 2, 2013
Last NPPES UpdateAugust 19, 20212 updates tracked since enumeration
NPPES CertifiedAugust 19, 2021
✔ NPI 1457788671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in FL · ARNP9318390
13047 W LINEBAUGH AVE STE 102, Tampa, FL 33626
Open in Google Maps ↗

Secondary Practice Location 1

Location 16919 N Dale Mabry Hwy Ste 300Tampa, FL 33614-3972 · Phone (813) 935-3221 · Fax (813) 933-8149

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

Ms. Kimberly T Randolph Arnp-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.

PECOS PAC ID2961710587
PECOS Enrollment IDI20151001001054
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kimberly Randolph reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Randolph Diabetes And Wellness LLC
Same address
Adult Medicine
13047 W LINEBAUGH AVE STE 102
Tampa, FL 33626
  • Reassigned Medicare billing, Florida enrollment
NPI 1609378991 (813) 475-6542

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
158 services39 patients
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211
This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
22 services12 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
17 services17 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33626 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RANDOLPH DIABETES AND WELLNESS LLC
Family Medicine (Adult Medicine)
13047 W LINEBAUGH AVE STE 102
TAMPA, FL 33626
Hillsborough County (813) 475-6542
CHANG-WILLIAMS MEDICAL, LLC
Physician Assistant (Medical)
13047 W LINEBAUGH AVE STE 102
TAMPA, FL 33626
Hillsborough County (813) 334-6134

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 Kimberly Randolph's NPI number?

The NPI number for Kimberly Randolph is 1457788671. It was assigned to this individual provider in the NPPES registry on October 2, 2013.

Where is Kimberly Randolph located?

Kimberly Randolph practices at 13047 W Linebaugh Ave Ste 102, Tampa, FL 33626. The listed phone number is (813) 475-6542.

What is Kimberly Randolph's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Kimberly Randolph enrolled in Medicare?

Yes. Kimberly 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 Kimberly Randolph's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Randolph reassigns Medicare benefits to Randolph Diabetes And Wellness LLC (Tampa, 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 Kimberly Randolph's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kimberly Randolph was last updated on August 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.