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DR. MARY KAY RANDOLPH MD
NPI 1841203023
Family Medicine in Polo, MO

Active since August 15, 2006PECOS EnrolledAccepts Medicare Assignment
36584 W 220TH ST, POLO, MO 64671(816) 809-7730 Get Directions Write a Review

NPPES record last updated: September 19, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 20, 2022, Jan 5, 2022, Nov 1, 2016 (3 updates tracked since 2016).

About Dr. Mary Kay Randolph Md NPPES

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

DR. MARY KAY RANDOLPH MD (NPI 1841203023) is an individual family medicine provider in Polo, Missouri, licensed in Missouri (101542) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Lafayette Regional Health Center, and is a graduate of University Of Kansas School Of Med (kc/wich/sal) (1992).

NPPES Registry Identity

NPI1841203023
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MARY KAY RANDOLPHCredential: MD
Location Address36584 W 220TH STPolo, MO 64671-8669
Mailing Address36584 W 220th StPolo, MO 64671-8669 · (816) 809-7730
Phone(816) 809-7730
Sole ProprietorNo
Medical School CMSUniversity Of Kansas School Of Med (kc/wich/sal)Graduated 1992
Enumeration DateAugust 15, 2006
Last NPPES UpdateSeptember 19, 20233 updates tracked since enumeration
NPPES CertifiedSeptember 19, 2023
✔ NPI 1841203023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in MO · 101542✔ Licensed in IL · 036-121726✔ Licensed in KS · 04-25049
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.
36584 W 220TH ST, Polo, MO 64671
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Other Identifiers 2

Other068002402KS · Medicare Ptan
Medicaid100175570CKS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Kansas City.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

Dr. Mary Kay 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 ID4385714534
PECOS Enrollment IDI20230613003221
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.

Hospital Affiliations CMS Care Compare

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

Lafayette Regional Health Center

Critical Access Hospitals · Lexington, MO
OwnershipProprietary
CMS Certification Number261320
Location1500 State StreetLexington, MO 64067 · Lafayette County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 64671 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
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
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.

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 Mary Randolph's NPI number?

The NPI number for Mary Randolph is 1841203023. It was assigned to this individual provider in the NPPES registry on August 15, 2006.

Where is Mary Randolph located?

Mary Randolph practices at 36584 W 220th St, Polo, MO 64671. The listed phone number is (816) 809-7730.

What is Mary Randolph's specialty?

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

Is Mary Randolph enrolled in Medicare?

Yes. Mary 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 Mary Randolph accept?

Health plans from Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Kansas City list Mary 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 Mary Randolph affiliated with any hospitals?

According to CMS data, Mary Randolph is affiliated with Lafayette Regional Health Center.

When was this NPI record last updated?

The NPPES record for Mary Randolph was last updated on September 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.