COLTON JASON RANDALL (PA-C) – Physician Assistant, NPI 1174148696
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,534 PHYSICIAN ASSISTANT in ID
Provider Addresses for COLTON JASON RANDALL (PA-C)
190 E BANNOCK ST
BOISE, ID 837126241
Phone:
Type: Mailing
775 POLE LINE RD W STE 112
TWIN FALLS, ID 833015819
Phone: (208) 814-8200
Fax: (208) 933-4921
Type: Location
3885 ORCHARD CIR
AMMON, ID 834064656
Phone: (208) 390-5105
Type: Mailing
856 BANKS LOWMAN RD
GARDEN VALLEY, ID 836228102
Phone: (208) 462-3533
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $448.
Total Amount is formed as General ($448) + Research ($0) + Ownership ($0) = $448.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Lexicon Pharmaceuticals, Inc. ($112).
Total Amount
$448
General + Research + Ownership
Payments
13
Total payment records
General Amount
$448
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2020-12-24
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20201224000479 | I | Physician Assistant | ID | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 194 | 137 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 120 | 22 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 93 | 70 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 56 | 56 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 44 | 35 | $0 |
Insurance plans in this area (ZIP 83712)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MI | |
| N E U R O S U R G E R Y | WA | |
| Internal Medicine | ID | |
| Qualified Audiologist | ID | |
| Thoracic Surgery, Cardiac Surgery | ID | |
| Family Practice | ID | |
| Physician Assistant | ID | |
| Cardiovascular Disease (Cardiology), Cardiac Electrophysiology | MI | |
| Physician Assistant | ID | |
| - | ID |
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