Theodore John Randolph, DPM in Port Jefferson Station, NY

Theodore John Randolph, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Port Jefferson Station, New York. His current practice location is 3 Medical Dr, Suite C, Port Jefferson Station, New York. You can reach out to his office (for appointments etc.) via phone at (631) 928-7785.

Theodore John Randolph is licensed to practice in New York (license number 003646) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1831197318.

Contact Information

	Theodore John Randolph, DPM
	3 Medical Dr, Suite C, Port Jefferson Station, NY 11776-1597
	(631) 928-7785
	(631) 928-0316

Map and Direction

Healthcare Provider's Profile

Full Name	Theodore John Randolph
Gender	Male
Speciality	Podiatrist - Foot & Ankle Surgery
Location	3 Medical Dr, Port Jefferson Station, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1831197318
Provider Enumeration Date: 07/08/2005
Last Update Date: 10/20/2011

Medicare PECOS Information:

PECOS PAC ID: 9436289436
Enrollment ID: I20100618000229

Medical Identifiers

Medical identifiers for Theodore John Randolph such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1831197318	NPI	-	NPPES
791048	Medicaid	NY

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
213ES0103X	Podiatrist - Foot & Ankle Surgery	003646 (New York)	Primary

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. Theodore John Randolph 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 Address	Practice Location Address
Theodore John Randolph, DPM 3 Medical Dr, Suite C, Port Jefferson Station, NY 11776-1597 Ph: (631) 928-7785	Theodore John Randolph, DPM 3 Medical Dr, Suite C, Port Jefferson Station, NY 11776-1597 Ph: (631) 928-7785

Reviews and Comments

Podiatrist in Port Jefferson Station, NY

Duan Zhang, Podiatrist Medicare: Medicare Enrolled Practice Location: 1 Medical Dr Ste B, Port Jefferson Station, NY 11776 Phone: 631-928-8383
Family Foot Care Of Long Island, Pllc Podiatrist Medicare: Medicare Enrolled Practice Location: 1 Medical Dr Ste B, Port Jefferson Station, NY 11776 Phone: 631-928-8383 Fax: 631-928-8388
Dr. Sean Lynch, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Dr Ste B, Port Jefferson Station, NY 11776 Phone: 631-928-8383 Fax: 631-928-8388
Dr. Warren L Kent, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 136 Terryville Rd, Port Jefferson Station, NY 11776 Phone: 631-928-1815
Dr. Stuart Plotkin, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 2 Medical Dr, Ste C, Port Jefferson Station, NY 11776 Phone: 631-928-8383 Fax: 631-928-8388
Dr. Meenakshi Singhal, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Dr Ste B, Port Jefferson Station, NY 11776 Phone: 631-928-8383 Fax: 631-928-8388
Warren L. Kent D.p.m. P.c. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 136 Terryville Rd, Port Jefferson Station, NY 11776 Phone: 631-928-1815 Fax: 631-928-2945

Theodore John Randolph, DPM - Medicare Podiatrist in Port Jefferson Station, NY