RANDOLPH COMMUNITY CLINIC SC
NPI 1497832257
Family Medicine in Randolph, WI
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
Specialties & Licenses
Other Identifiers 5
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Randolph Community Clinic Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Randolph Community Clinic Sc, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, WIFrequently 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.
Is Randolph Community Clinic Sc enrolled in Medicare?
Yes. Randolph Community Clinic Sc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Randolph Community Clinic Sc?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Randolph Community Clinic Sc, in Family Practice and Nurse Practitioner. A 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 the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, Dean Health Plan, 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.
# Randolph Community Clinic Sc · NPI 1497832257
Family Medicine organization in Randolph, Wisconsin. Organization record, active in the CMS NPPES registry since November 1, 2006.
## Identity
- **NPI:** 1497832257 (Entity type: Organization)
- **Enumerated:** November 1, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Melissa Lucarelli, PRESIDENT
## Practice location
- **Address:** 504 S HIGH STREET, Randolph, WI 53956
- **Phone:** (920) 326-5060 · **Fax:** (920) 326-5061
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Nurse Practitioner (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 20, 2008
- **Other identifiers:** Medicare UPIN G14013; Other =========016; Other CH8761; and 2 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1497832257) · Data from the CMS NPPES public registry.