DR. RANDALL MARK JR. STUCKEY (D.O.) – Family Medicine Physician, NPI 1114361003

DR. RANDALL MARK JR. STUCKEY (D.O.) is a healthcare provider. based in Hutchinson, Minnesota. specializing in FAMILY PRACTICE, EMERGENCY MEDICINE. They hold the professional credentials D.O.. They hold a License No. 58231 (MN). The NPI Number for DR. RANDALL MARK JR. STUCKEY (D.O.) is 1114361003

Main info

Male
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
DR. RANDALL MARK JR. STUCKEY (D.O.)
NPI
1114361003
Phone
(320) 234-3290
Address
3 CENTURY AVE SE
Enumeration Date
22 April 2013
Last Update Date
28 June 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3202345000
Graduation Year
2013 (13 years ago)
PAC ID
7911129473
Group Practice PAC ID
0345330072
Professional Enrollment ID
I20150625002429
Address ID
MN553505000HU1095XSXXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:13State licenses:1Digital endpointsOther names

3,075 FAMILY PRACTICE in MN

Provider Addresses for DR. RANDALL MARK JR. STUCKEY (D.O.)

  • 3 CENTURY AVE SE

    HUTCHINSON, MN 553503108

    Phone: (320) 234-3290

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2015-06-25

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
I20150625002429IFamily PracticeMNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes227131$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit5858$0
99213Established patient office or other outpatient visit, 20-29 minutes3532$0
99215Established patient office or other outpatient visit, 40-54 minutes3024$0
G0500Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito1717$0
View full utilization report →

Insurance plans in this area (ZIP 55350)

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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: 0345330072View full group profile
NameSpecialtyState
Cardiac ElectrophysiologyMN
Family PracticeMN
Certified Registered Nurse Anesthetist (Crna)MN
-MN
Internal MedicineMN
Nurse PractitionerMN
Physician AssistantIL
Internal MedicineMI
Nurse PractitionerMN
Orthopedic SurgeryMN

Reviews

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Frequently asked questions

What NPI should I save for DR. RANDALL MARK JR. STUCKEY (D.O.)?
Save NPI 1114361003 if you need a stable reference for DR. RANDALL MARK JR. STUCKEY (D.O.).
Is DR. RANDALL MARK JR. STUCKEY (D.O.) active in the national directory?
DR. RANDALL MARK JR. STUCKEY (D.O.)'s public NPI profile is in an active state.
Can you summarize DR. RANDALL MARK JR. STUCKEY (D.O.)'s specialty in plain language?
Clinically, the directory lists DR. RANDALL MARK JR. STUCKEY (D.O.) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What location shows for DR. RANDALL MARK JR. STUCKEY (D.O.)?
We surface Hutchinson, Minnesota for DR. RANDALL MARK JR. STUCKEY (D.O.) based on available NPPES addresses.
Is DR. RANDALL MARK JR. STUCKEY (D.O.) a real provider?
This page reflects official NPPES data for NPI 1114361003. Always confirm identity and privileges with the practice and licensing boards.

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