MERCEDES RANDOLPH (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1053656447

MERCEDES RANDOLPH (PMHNP) is a healthcare provider. based in Loveland, Colorado. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. 824676 (CA). The NPI Number for MERCEDES RANDOLPH (PMHNP) is 1053656447

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
MERCEDES RANDOLPH (PMHNP)
NPI
1053656447
Phone
(970) 593-3300
Address
4575 BYRD DR
Enumeration Date
11 December 2012
Last Update Date
14 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7025894871
Graduation Year
2023 (3 years ago)
PAC ID
3678010659
Group Practice PAC ID
7214296409
Professional Enrollment ID
I20240808000957
Address ID
CO802461325DE501XXSTXX403
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:13State licenses:2Digital endpointsOther names

5,201 NURSE PRACTITIONER in CO

Provider Addresses for MERCEDES RANDOLPH (PMHNP)

  • 4575 BYRD DR

    LOVELAND, CO 805387198

    Phone: (970) 593-3300

    Type: Location

  • 200 CASENTINI ST

    SALINAS, CA 939072299

    Phone: (831) 758-9457

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $90.

Total Amount is formed as General ($90) + Research ($0) + Ownership ($0) = $90.

Last reported payment date: 2024-11-13 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($90).

Total Amount

$90

General + Research + Ownership

Payments

5

Total payment records

General Amount

$90

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-13

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Merck Sharp & Dohme LLC$90
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240808000957INurse PractitionerCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 80538)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7214296409View full group profile
NameSpecialtyState
Nurse PractitionerCO
-CO
Mental Health CounselorTX
Clinical Social WorkerCO
Nurse PractitionerCO
P S Y C H I A T R YNV
Physician AssistantCO
Nurse PractitionerTX
Nurse PractitionerCO
Physician AssistantTN

Reviews

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Frequently asked questions

Is there an official ID for MERCEDES RANDOLPH (PMHNP) in U.S. healthcare records?
The official identifier for MERCEDES RANDOLPH (PMHNP) is NPI 1053656447.
Would MERCEDES RANDOLPH (PMHNP) appear as active to a payer?
You can treat MERCEDES RANDOLPH (PMHNP) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe MERCEDES RANDOLPH (PMHNP)'s focus?
For MERCEDES RANDOLPH (PMHNP), the primary taxonomy reads as Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with MERCEDES RANDOLPH (PMHNP)?
Directory geography for MERCEDES RANDOLPH (PMHNP) centers on Loveland, Colorado.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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