DR. KYLE ROBERT RANDALL (MD) – Orthopaedic Surgery Physician, NPI 1154396364

DR. KYLE ROBERT RANDALL (MD) is a healthcare provider. based in Grand rapids, Michigan. specializing in ORTHOPEDIC SURGERY. They hold the professional credentials MD. They hold a License No. 4301061642 (MI). The NPI Number for DR. KYLE ROBERT RANDALL (MD) is 1154396364

Main info

Male
Sole Proprietor
33 Years Of Experience
Accepts Medicare Assignment
Name
DR. KYLE ROBERT RANDALL (MD)
NPI
1154396364
Phone
(616) 451-9925
Address
2911 KNAPP ST NE
Enumeration Date
21 February 2006
Last Update Date
21 November 2014

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9063412153
Graduation Year
1993 (33 years ago)
PAC ID
1254399793
Group Practice PAC ID
4082525118
Professional Enrollment ID
I20041229000958
Address ID
MI498548992MA7870W2XXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,081 ORTHOPEDIC SURGERY in MI

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Provider Addresses for DR. KYLE ROBERT RANDALL (MD)

  • 2911, Knapp Street Northeast, Grand Rapids Charter Township, Kent County, Michigan, 49525, United States

    SUITE A

    GRAND RAPIDS, MI 49525

    Phone: (616) 451-9925

    Fax: (616) 328-5380

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 16 Open Payments records for all available years, with a total value of $747.

Total Amount is formed as General ($747) + Research ($0) + Ownership ($0) = $747.

Last reported payment date: 2024-08-22 • Largest payer in this snapshot: True North Surgical Inc ($523).

Total Amount

$747

General + Research + Ownership

Payments

16

Total payment records

General Amount

$747

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-22

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2004-12-29

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
I20041229000958IOrthopedic SurgeryMITBD

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 49525)

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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: 4082525118View full group profile
NameSpecialtyState
-MI
Family PracticeOH
-MI
Nurse PractitionerMI
Emergency Medicine, Internal MedicineMI
Nurse PractitionerMI
Nurse PractitionerMI
General PracticeMI
Nurse PractitionerMI
Family PracticeMI

Reviews

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Frequently asked questions

What identifier follows DR. KYLE ROBERT RANDALL (MD) across health systems?
The NPI 1154396364 uniquely identifies DR. KYLE ROBERT RANDALL (MD) in U.S. healthcare data.
Is DR. KYLE ROBERT RANDALL (MD) currently accepting referrals based on NPI status?
Registry metadata lists DR. KYLE ROBERT RANDALL (MD) as active.
What does the directory say DR. KYLE ROBERT RANDALL (MD) does?
Insurance directories may phrase it differently, but here DR. KYLE ROBERT RANDALL (MD) maps to Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
Is DR. KYLE ROBERT RANDALL (MD) tied to Grand Rapids, Michigan?
If you are local to Grand Rapids, Michigan, DR. KYLE ROBERT RANDALL (MD) may be relevant to your search.
Why is information missing for DR. KYLE ROBERT RANDALL (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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