RANDOLPH K CRIBBS (MD) – Surgery Physician, NPI 1770675563

RANDOLPH K CRIBBS (MD) is a healthcare provider. based in Clackamas, Oregon. specializing in GENERAL SURGERY. They hold the professional credentials MD. They hold a License No. MD168029 (OR). The NPI Number for RANDOLPH K CRIBBS (MD) is 1770675563

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
RANDOLPH K CRIBBS (MD)
NPI
1770675563
Phone
(503) 215-2890
Address
9290 SE SUNNYBROOK BLVD STE 220
Enumeration Date
29 September 2006
Last Update Date
19 February 2021

Doctor Profile

Medical School Name
PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
5039469704
Graduation Year
1992 (34 years ago)
PAC ID
3274614169
Group Practice PAC ID
4082140413
Professional Enrollment ID
I20180809005374
Address ID
OR972012548PO1410XSTXX400
Telehealth
Yes

Contacts

Secure Messaging
rcribbs481613@oc.providencedirect.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

530 GENERAL SURGERY in OR

Provider Addresses for RANDOLPH K CRIBBS (MD)

  • 9290 SE SUNNYBROOK BLVD STE 220

    CLACKAMAS, OR 97015

    Phone: (503) 215-2890

    Type: Location

  • 3158, Southwest 87th Avenue, Portland, Metro, Washington County, Oregon, 97225, United States

    PORTLAND, OR 972083158

    Phone:

    Type: Mailing

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: 2018-08-09

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
I20180809005374IGeneral SurgeryORTBD

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 97015)

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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: 4082140413View full group profile
NameSpecialtyState
Interventional Pain Management, Pain ManagementOR

Reviews

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Frequently asked questions

What number should I use to identify RANDOLPH K CRIBBS (MD) for billing?
Administrative and clinical systems typically use NPI 1770675563 for RANDOLPH K CRIBBS (MD).
Should I treat RANDOLPH K CRIBBS (MD) as an active provider?
Patients and plans typically see RANDOLPH K CRIBBS (MD) as active in the national extract.
How should patients interpret RANDOLPH K CRIBBS (MD)'s specialty?
The extract shows Surgery Physician for RANDOLPH K CRIBBS (MD). Clinical services aligned with this taxonomy classification.
What geographic area is tied to RANDOLPH K CRIBBS (MD)?
RANDOLPH K CRIBBS (MD) is associated with Clackamas, Oregon in the same public data insurers reference.
Why is information missing for RANDOLPH K CRIBBS (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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