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RANDOLPH COMMUNITY CLINIC SC
NPI 1497832257
Family Medicine in Randolph, WI

Active since November 01, 2006CLIA 52D0980872 · Microscopy
504 S HIGH STREET, RANDOLPH, WI 53956(920) 326-5060(920) 326-5061 Get Directions Write a Review

NPPES record last updated: April 20, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Randolph Community Clinic Sc NPPES

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

RANDOLPH COMMUNITY CLINIC SC (NPI 1497832257) is a healthcare organization registered as a family medicine in Randolph, Wisconsin and active in the NPI registry since November 2006. The organization holds a CLIA Microscopy certificate valid through December 5, 2026 and lists Melissa Elaine Lucarelli, President, as its authorized official.

NPPES Registry Identity

NPI1497832257
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameRANDOLPH COMMUNITY CLINIC SC
Location Address504 S HIGH STREETRandolph, WI 53956
Mailing Address504 S High St, Po Box 101Randolph, WI 53956-1499 · (920) 326-5060 · Fax (920) 326-5061
Phone(920) 326-5060
Fax(920) 326-5061
Organization SubpartNo
Authorized OfficialMelissa Elaine LucarelliPresident · (920) 326-5060
Enumeration DateNovember 1, 2006
Last NPPES UpdateApril 20, 2008
✔ NPI 1497832257 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 36988020
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
504 S HIGH STREET, Randolph, WI 53956
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Other Identifiers 5

Medicare UPING14013
Other=========016Blue Cross
OtherCH8761Railroad Medicare
OtherN96Dean Health Plan
Medicaid32327000WI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Quartz, Security Health Plan.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 52D0980872

Randolph Community Clinic Sc · Randolph, WI
Active · expires Dec 5, 2026
CLIA Number52D0980872
Laboratory TypePhysician Office
Certificate Effective DateDecember 6, 2024
Certificate Expiration DateDecember 5, 2026
Laboratory DirectorMelissa E. Lucarelli MD
Laboratory Phone(920) 326-5060
Laboratory LocationRandolph Community Clinic Sc504 S High St, Randolph, WI 53956
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

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

MELISSA ELAINE LUCARELLI MD
Family Medicine
504 S HIGH STREET
RANDOLPH, WI 53956
Dodge County (920) 326-5060

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 Randolph Community Clinic Sc's NPI number?

The NPI number for Randolph Community Clinic Sc is 1497832257. It was assigned to this organization in the NPPES registry on November 1, 2006.

Where is Randolph Community Clinic Sc located?

Randolph Community Clinic Sc is located at 504 S High Street, Randolph, WI 53956. The listed phone number is (920) 326-5060.

What is Randolph Community Clinic Sc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Randolph Community Clinic Sc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 52D0980872) is associated with this NPI, valid through December 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Randolph Community Clinic Sc accept?

Health plans from Anthem Blue Cross and Blue Shield, Quartz and Security Health Plan list Randolph Community Clinic Sc 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 Randolph Community Clinic Sc was last updated on April 20, 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.