DR. RANDALL L BRADDOM (M.D.) – Physical Medicine & Rehabilitation Physician, NPI 1255302360

DR. RANDALL L BRADDOM (M.D.) is a healthcare provider. based in The villages, Florida. specializing in PHYSICAL MEDICINE AND REHABILITATION. They hold the professional credentials M.D.. They hold a License No. 25MA02637400 (NJ). The NPI Number for DR. RANDALL L BRADDOM (M.D.) is 1255302360

Main info

Male
Sole Proprietor
58 Years Of Experience
Accepts Medicare Assignment
Name
DR. RANDALL L BRADDOM (M.D.)
NPI
1255302360
Phone
(908) 601-7036
Address
1093 GOLDEN GROVE DR
Enumeration Date
27 January 2006
Last Update Date
3 June 2013

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
3526896400
Graduation Year
1968 (58 years ago)
PAC ID
0648395277
Professional Enrollment ID
I20150206001345
Address ID
FL344843750OX5050XRDXX301
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

833 PHYSICAL MEDICINE AND REHABILITATION in FL

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Provider Addresses for DR. RANDALL L BRADDOM (M.D.)

  • 1093, Golden Grove Drive, The Villages, Sumter County, Florida, 32162, United States

    THE VILLAGES, FL 321624023

    Phone: (908) 601-7036

    Fax: (352) 561-4512

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2015-02-06

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
I20150206001345IPhysical Medicine And RehabilitationFLTBD

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 32162)

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Reviews

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Frequently asked questions

Is DR. RANDALL L BRADDOM (M.D.) listed with a National Provider Identifier?
Yes — DR. RANDALL L BRADDOM (M.D.) has NPI 1255302360 on file in the registry.
Is DR. RANDALL L BRADDOM (M.D.) still an active registrant?
DR. RANDALL L BRADDOM (M.D.) carries an active NPI according to the public dataset.
What kind of doctor is DR. RANDALL L BRADDOM (M.D.)?
DR. RANDALL L BRADDOM (M.D.) is associated with Physical Medicine & Rehabilitation Physician in the directory — Clinical services aligned with this taxonomy classification.
Is DR. RANDALL L BRADDOM (M.D.) located near The Villages?
DR. RANDALL L BRADDOM (M.D.) currently maps to The Villages, Florida in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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