DR. RANDY J KJORSTAD (M.D.) – Surgery Physician, NPI 1043283336
Surgery Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
530 GENERAL SURGERY in OR
Provider Addresses for DR. RANDY J KJORSTAD (M.D.)
1315 NW 4TH ST STE A
REDMOND, OR 977561328
Phone: (541) 548-7761
Fax: (541) 598-3485
Type: Location
555 E Broadway Ave
Suite 229
Jackson, WY 830018640
Phone: (307) 739-7690
Fax: (307) 739-7644
Type: Location
428, Works Road, Jackson, Waldo County, Maine, United States
JACKSON, WY 830010428
Phone: (307) 739-7690
Fax: (307) 739-7644
Type: Mailing
555, Broadway Avenue, Woodland Hills, Jackson, Hinds County, Mississippi, 39216, United States
SUITE 229
JACKSON, WY 830018640
Phone: (307) 739-7690
Fax: (307) 739-7644
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $1,326.
Total Amount is formed as General ($1,326) + Research ($0) + Ownership ($0) = $1,326.
Last reported payment date: 2024-09-18 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($1,154).
Total Amount
$1,326
General + Research + Ownership
Payments
6
Total payment records
General Amount
$1,326
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Intuitive Surgical, Inc. | $1,154 |
| Davol Inc. | $173 |
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: 2023-09-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20140702002454 | I | General Surgery | WY | TBD |
| I20230906003016 | I | General Surgery | OR | 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 |
|---|---|---|---|---|
| 45380 | Biopsy of large bowel using a flexible endoscope | 76 | 76 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 37 | 37 | $0 |
| 43239 | Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 32 | 31 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 27 | 23 | $0 |
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 24 | 24 | $0 |
Insurance plans in this area (ZIP 97756)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | OR | |
| Orthopedic Surgery | NM | |
| Family Practice | OR | |
| Nurse Practitioner | OR | |
| Hand Surgery | OR | |
| Diagnostic Radiology | OR | |
| Physician Assistant | OR | |
| Nurse Practitioner | OR | |
| - | OR | |
| - | OR |
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