Derrick Randdolf, MD - Medicare Family Practice in Odessa, TX

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Derrick Randdolf, MD is a medicare enrolled "Emergency Medicine" physician in Odessa, Texas. He graduated from medical school in 2012 and has 12 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Concord Medical Group Of Texas Pllc, Odessa Physician Associates Pllc and his current practice location is 701 W 5th St, Odessa, Texas. You can reach out to his office (for appointments etc.) via phone at (432) 703-5375.

Derrick Randdolf is licensed to practice in Texas (license number R4622) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1104205343.

Contact Information

Derrick Randdolf, MD
701 W 5th St,
Odessa, TX 79763-4206
(432) 703-5375
(432) 703-5238

Map and Direction




Physician's Profile

Full NameDerrick Randdolf
GenderMale
SpecialityFamily Practice
Experience12 Years
Location701 W 5th St, Odessa, Texas
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Derrick Randdolf graduated from medical school in 2012
  NPI Data:
  • NPI Number: 1104205343
  • Provider Enumeration Date: 05/20/2015
  • Last Update Date: 05/22/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 8426348178
  • Enrollment ID: I20171130001563

Medical Identifiers

Medical identifiers for Derrick Randdolf such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104205343NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine R4622 (Texas)Secondary
390200000XStudent In An Organized Health Care Education/training Program (* (Not Available))Secondary
207P00000XEmergency Medicine R4622 (Texas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Scenic Mountain Medical Center, A Steward Family HBig spring, TXHospital
Baptist Emergency HospitalSan antonio, TXHospital
Odessa Regional Medical CenterOdessa, TXHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Concord Medical Group Of Texas Pllc7810117223258
Odessa Physician Associates Pllc842694011515

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Derrick Randdolf allows following entities to bill medicare on his behalf.
Entity NameThird Coast Emergency Physicians Southwest Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1497793475
PECOS PAC ID: 6800794447
Enrollment ID: O20031222000126
Entity NameOdessa Physician Associates Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457398364
PECOS PAC ID: 8426940115
Enrollment ID: O20040326001291
Entity NameSeminole Hospital District Of Gaines County Texas
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1821025990
PECOS PAC ID: 2668382516
Enrollment ID: O20040428000104
Entity NameTravis County Emergency Physicians Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1962440933
PECOS PAC ID: 0840289468
Enrollment ID: O20040510000492
Entity NameTexas Emergency Staffing Solutions Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1811942949
PECOS PAC ID: 0345297610
Enrollment ID: O20050407001290
Entity NameConcord Medical Group Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083630610
PECOS PAC ID: 0446296818
Enrollment ID: O20050707000531
Entity NameConcord Medical Group Of Texas Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750790762
PECOS PAC ID: 7810117223
Enrollment ID: O20141007002567
Entity NameHospital Care Consultants Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1912945635
PECOS PAC ID: 9032131735
Enrollment ID: O20150915001950
Entity NameHospital Care Consultants Of Corpus Christi
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275088452
PECOS PAC ID: 5092093153
Enrollment ID: O20161025002578
Entity NameEmergency Associates Of Central Texas Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1215418280
PECOS PAC ID: 6800147216
Enrollment ID: O20180925001294
Entity NameHospitalist Medicine Physicians Of Texas - Houston, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760028740
PECOS PAC ID: 2860881125
Enrollment ID: O20211109000125
Entity NameTexas Regional Healthcare Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407500465
PECOS PAC ID: 5496141459
Enrollment ID: O20220331001394

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Derrick Randdolf is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Derrick Randdolf, MD
701 W 5th St,
Odessa, TX 79763-4206

Ph: (432) 703-5375		Derrick Randdolf, MD
701 W 5th St,
Odessa, TX 79763-4206

Ph: (432) 703-5375

Reviews and Comments


Emergency Medicine Doctors in Odessa, TX

Dr. Steven Wiese, MD
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Phone: 979-575-8119    
Jeffery M Pinnow, M.D.
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Kyungho Scott Choi, MD
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Cordell Cunningham, M.D.
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Farshid D Kayfan, MD
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Dr. Michael Duane Simmons, MD
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Practice Location: 500 W 4th St, Odessa, TX 79761
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Randal Isaac Hale, M.D.
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Medicare: Medicare Enrolled
Practice Location: 701 W 5th St, Odessa, TX 79763
Phone: 432-335-2222    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.