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CHARLES D RANDOLPH MD
NPI 1760040281
Family Medicine in Grand Coulee, WA

Active since May 30, 2019PECOS EnrolledAccepts Medicare Assignment
97.58/100
CMS Quality Rating
411 FORTUYN RD, GRAND COULEE, WA 99133(509) 633-1911(509) 633-3644 Get Directions Write a Review

NPPES record last updated: July 7, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 7, 2022, May 30, 2019 (2 updates tracked since 2019).

About Charles D Randolph Md NPPES

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

CHARLES D RANDOLPH MD (NPI 1760040281) is an individual family medicine provider in Grand Coulee, Washington, licensed in Washington (MD61172546) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS, is affiliated with Coulee Medical Center, and is a graduate of Loma Linda University School Of Medicine (2019).

NPPES Registry Identity

NPI1760040281
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameCHARLES D RANDOLPHCredential: MD
Location Address411 FORTUYN RDGrand Coulee, WA 99133-8718
Mailing Address411 Fortuyn RdGrand Coulee, WA 99133-8718 · (509) 633-1911 · Fax (509) 633-3644
Phone(509) 633-1911
Fax(509) 633-3644
Sole ProprietorNo
Medical School CMSLoma Linda University School Of MedicineGraduated 2019
Enumeration DateMay 30, 2019
Last NPPES UpdateJuly 7, 20222 updates tracked since enumeration
NPPES CertifiedJuly 7, 2022
✔ NPI 1760040281 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WA · MD61172546
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.
411 FORTUYN RD, Grand Coulee, WA 99133
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Other Identifiers 1

Medicaid2136043WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.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

Charles D Randolph Md 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 ID1254667439
PECOS Enrollment IDI20220526001092
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.

Areas of Expertise CMS Part B claims

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
68 services23 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Coulee Medical Center

Critical Access Hospitals · Grand Coulee, WA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number501308
Location411 Fortuyn RoadGrand Coulee, WA 99133 · Grant County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99133 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$100.78 typical visit price
range $18.56 – $141.11
Typical copayment $25.19 (range $4.64 – $35.27)
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.

Medicare 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.

97.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.53
Promoting Interoperability100
Improvement Activities40

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.

ANNA HARDESTY PT
Physical Therapist
411 FORTUYN RD
GRAND COULEE, WA 99133
Grant County (509) 633-3260
DOUGLAS, GRANT, LINCOLN AND OKANOGAN COUTIES PUBLIC HOSP. DIST. #6
Clinic/Center (Primary Care)
411 FORTUYN RD
GRAND COULEE, WA 99133
Grant County (509) 633-1753
DOUGLAS, GRANT, LINCOLN AND OKANOGAN COUNTIES HOSPITAL DISTRICT #6
Long Term Care Hospital
411 FORTUYN RD
GRAND COULEE, WA 99133
Grant County (509) 633-6388
DOUGLAS, GRANT, LINCOLN AND OKANOGAN COUNTIES HOSPITAL DISTRICT NO. 6
General Acute Care Hospital (Critical Access)
411 FORTUYN RD
GRAND COULEE, WA 99133
Grant County (509) 633-6388
JENNIFER KNOX MD
Family Medicine
411 FORTUYN RD
GRAND COULEE, WA 99133
Grant County (509) 633-1753
AMY ANNE HADEN
Registered Nurse
411 FORTUYN RD
GRAND COULEE, WA 99133
Grant County (509) 633-1753
ALLY A WEBB PA-C
Physician Assistant
411 FORTUYN RD
GRAND COULEE, WA 99133
Grant County (509) 633-1753
DOUGLAS, GRANT, LINCOLN & OKANOGAN COUNTIES PUBLIC HOSPITAL DISTRICT 6
General Acute Care Hospital (Critical Access)
411 FORTUYN RD
GRAND COULEE, WA 99133
Grant County (509) 633-1753

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 Charles Randolph's NPI number?

The NPI number for Charles Randolph is 1760040281. It was assigned to this individual provider in the NPPES registry on May 30, 2019.

Where is Charles Randolph located?

Charles Randolph practices at 411 Fortuyn Rd, Grand Coulee, WA 99133. The listed phone number is (509) 633-1911.

What is Charles Randolph's specialty?

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

Is Charles Randolph enrolled in Medicare?

Yes. Charles 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 Charles Randolph accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Charles 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.

Is Charles Randolph affiliated with any hospitals?

According to CMS data, Charles Randolph is affiliated with Coulee Medical Center.

When was this NPI record last updated?

The NPPES record for Charles Randolph was last updated on July 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.