CLEVELAND W JR. RANDOLPH (M.D.) – Specialist, NPI 1124014287

CLEVELAND W JR. RANDOLPH (M.D.) is a healthcare provider. based in Jacksonville beach, Florida. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials M.D.. They hold a License No. ME42493 (FL). The NPI Number for CLEVELAND W JR. RANDOLPH (M.D.) is 1124014287

Main info

Male
Sole Proprietor
44 Years Of Experience
Accepts Medicare Assignment
Name
CLEVELAND W JR. RANDOLPH (M.D.)
NPI
1124014287
Phone
(904) 249-3743
Address
1891 BEACH BLVD
Enumeration Date
23 September 2005
Last Update Date
18 August 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9042493743
Graduation Year
1982 (44 years ago)
PAC ID
9739173345
Group Practice PAC ID
5496749004
Professional Enrollment ID
I20040504000250
Address ID
FL322502644JA1891XBLVD301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,538 OBSTETRICS/GYNECOLOGY in FL

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Provider Addresses for CLEVELAND W JR. RANDOLPH (M.D.)

  • 1891, Beach Boulevard, Jacksonville Beach, Duval County, Florida, 32250, United States

    STE. 200

    JACKSONVILLE BEACH, FL 322502644

    Phone: (904) 249-3743

    Fax: (904) 249-2047

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $33.

Total Amount is formed as General ($33) + Research ($0) + Ownership ($0) = $33.

Last reported payment date: 2024-07-01 • Largest payer in this snapshot: Astellas Pharma US Inc ($19).

Total Amount

$33

General + Research + Ownership

Payments

2

Total payment records

General Amount

$33

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-01

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2004-05-04

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
I20040504000250IObstetrics/GynecologyFLTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
76830Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina5145$0
View full utilization report →

Insurance plans in this area (ZIP 32250)

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Provider's Procedures

CLEVELAND W JR. RANDOLPH (M.D.) performs procedures in OBSTETRICS/GYNECOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OBSTETRICS/GYNECOLOGYFL81002Urinalysis, manual test158152

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: 5496749004View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerOH
O B S T E T R I C S/ G Y N E C O L O G YFL
Nurse PractitionerFL
-FL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What identifier follows CLEVELAND W JR. RANDOLPH (M.D.) across health systems?
The NPI 1124014287 uniquely identifies CLEVELAND W JR. RANDOLPH (M.D.) in U.S. healthcare data.
Does the public listing show CLEVELAND W JR. RANDOLPH (M.D.) as active?
CLEVELAND W JR. RANDOLPH (M.D.)'s NPI record reflects an active status in NPPES.
What services align with CLEVELAND W JR. RANDOLPH (M.D.)'s listing?
CLEVELAND W JR. RANDOLPH (M.D.)'s public classification highlights Other Service Providers. Clinical services aligned with this taxonomy classification.
Is CLEVELAND W JR. RANDOLPH (M.D.) tied to Jacksonville Beach, Florida?
If you are local to Jacksonville Beach, Florida, CLEVELAND W JR. RANDOLPH (M.D.) may be relevant to your search.
Who maintains CLEVELAND W JR. RANDOLPH (M.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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