M. BARRY RANDALL (M.D.) – Dermatopathology (Pathology) Physician, NPI 1124002175

M. BARRY RANDALL (M.D.) is a healthcare provider. based in Memphis, Tennessee. specializing in PATHOLOGY. They hold the professional credentials M.D.. They hold a License No. 29321 (TN). The NPI Number for M. BARRY RANDALL (M.D.) is 1124002175

Main info

Male
40 Years Of Experience
Accepts Medicare Assignment
Name
M. BARRY RANDALL (M.D.)
NPI
1124002175
Phone
(901) 866-8375
Address
1407 UNION AVE
Enumeration Date
2 December 2005
Last Update Date
25 February 2025

Doctor Profile

Medical School Name
UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF MEDICINE
Secondary Phone
9015457259
Graduation Year
1986 (40 years ago)
PAC ID
3375672272
Group Practice PAC ID
6608784855
Professional Enrollment ID
I20100603000038
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

459 PATHOLOGY in TN

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Provider Addresses for M. BARRY RANDALL (M.D.)

  • 1407, Union Avenue, Annesdale Park, Memphis, Shelby County, Tennessee, 38104, United States

    SUITE 700

    MEMPHIS, TN 381043627

    Phone: (901) 866-8375

    Fax: (901) 302-2360

    Type: Mailing

  • Hamilton Eye Institute, 930, Madison Avenue, Medical District, Dixie Homes, Memphis, Shelby County, Tennessee, 38163, United States

    SUITE 890

    MEMPHIS, TN 381033410

    Phone: (901) 866-8834

    Fax: (901) 302-2834

    Type: Location

  • 1068 CRESTHAVEN RD STE 300

    MEMPHIS, TN 381190809

    Phone:

    Type: Mailing

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: 2010-06-03

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
I20100603000038IPathologyTNTBD

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 38104)

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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: 6608784855View full group profile
NameSpecialtyState
Medical OncologyTN
Diagnostic Radiology, Diagnostic Radiology, Undefined Physician Type (Specify)TN
P A T H O L O G YNC
H E M A T O L O G Y/ O N C O L O G YTN
P A T H O L O G YTN
P A T H O L O G YTN
Nurse PractitionerAR
P A T H O L O G YOH
Hematology/Oncology, Internal MedicineTN
P A T H O L O G YTN

Reviews

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Frequently asked questions

Can I verify M. BARRY RANDALL (M.D.) with an NPI only?
You can start verification with NPI 1124002175 for M. BARRY RANDALL (M.D.), then check state licensing separately.
Can I rely on M. BARRY RANDALL (M.D.) being an active provider?
As of the registry snapshot, M. BARRY RANDALL (M.D.) is marked active.
What is M. BARRY RANDALL (M.D.)'s specialty?
The listing groups M. BARRY RANDALL (M.D.) with Dermatopathology (Pathology) Physician. Clinical services aligned with this taxonomy classification.
What address line appears for M. BARRY RANDALL (M.D.)?
M. BARRY RANDALL (M.D.)'s geographic hint is Memphis, Tennessee in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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