Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jared D Randall

Individual provider Physician Assistant · NPI 1124873070

Jared D Randall is a Physician Assistant in Baltimore, Maryland. Qualified in 2025, 1 year ago. Practices with Lifebridge Orthopedic Specialists LLC, a 47-clinician group and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
1
Licensed in
MD
In the registry since
2024
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Practice location Address checks out

2401 W Belvedere Ave
Baltimore, MD 21215-5270
Phone: (501) 557-8282
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence C0009955 (MD)

Record details

NPI number1124873070
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 23, 2024
Last updated in NPPESSeptember 17, 2025
Certification dateSeptember 17, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Lifebridge Orthopedic Specialists Llc — 47 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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