DR. JOHN WILFRED RANDALL (OD, MPH) – Optometrist, NPI 1982695524

DR. JOHN WILFRED RANDALL (OD, MPH) is a healthcare provider. based in Forest grove, Oregon. specializing in OPTOMETRY. They hold the professional credentials OD, MPH. They hold a License No. 1610AT (OR). The NPI Number for DR. JOHN WILFRED RANDALL (OD, MPH) is 1982695524

Main info

Male
46 Years Of Experience
Accepts Medicare Assignment
Name
DR. JOHN WILFRED RANDALL (OD, MPH)
NPI
1982695524
Phone
(503) 352-2020
Address
2043 COLLEGE WAY
Enumeration Date
2 November 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
9286723000
Graduation Year
1980 (46 years ago)
PAC ID
8820074156
Group Practice PAC ID
3678558129
Professional Enrollment ID
I20050107000114
Address ID
AZ860447397TOHWYXX16XX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:20State licenses:2Digital endpointsOther names

672 OPTOMETRY in OR

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Provider Addresses for DR. JOHN WILFRED RANDALL (OD, MPH)

  • Pacific University, 2043, College Way, Forest Grove, Metro, Washington County, Oregon, 97116, United States

    PACIFIC UNIVERSITY COLLEGE OF OPTOMETRY

    FOREST GROVE, OR 971161756

    Phone: (503) 352-2020

    Fax: (503) 352-2929

    Type: Location

  • 30 EILER LN

    ZILLAH, WA 989539731

    Phone: (509) 865-1877

    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: 2005-01-07

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
I20050107000114IOptometryTXTBD

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 97116)

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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: 3678558129View full group profile

Reviews

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Frequently asked questions

What NPI should I save for DR. JOHN WILFRED RANDALL (OD, MPH)?
Save NPI 1982695524 if you need a stable reference for DR. JOHN WILFRED RANDALL (OD, MPH).
Is DR. JOHN WILFRED RANDALL (OD, MPH) active in the national directory?
DR. JOHN WILFRED RANDALL (OD, MPH)'s public NPI profile is in an active state.
What field does DR. JOHN WILFRED RANDALL (OD, MPH) work in?
You can think of DR. JOHN WILFRED RANDALL (OD, MPH) as practicing within Optometrist. Clinical services aligned with this taxonomy classification.
Where is DR. JOHN WILFRED RANDALL (OD, MPH)'s primary listing?
We display Forest Grove, Oregon because that is what the record indicates for DR. JOHN WILFRED RANDALL (OD, MPH).
Is DR. JOHN WILFRED RANDALL (OD, MPH) a real provider?
This page reflects official NPPES data for NPI 1982695524. Always confirm identity and privileges with the practice and licensing boards.