NICHOLAS REED RANDALL (MD) – Plastic Surgery within the Head & Neck (Otolaryngology) Physician, NPI 1093229452

NICHOLAS REED RANDALL (MD) is a healthcare provider. based in Spokane, Washington. specializing in OTOLARYNGOLOGY. They hold the professional credentials MD. They hold a License No. 31662 (MN). The NPI Number for NICHOLAS REED RANDALL (MD) is 1093229452

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLAS REED RANDALL (MD)
NPI
1093229452
Phone
(509) 358-7500
Address
412 E Spokane Falls Blvd
Enumeration Date
21 November 2017
Last Update Date
12 September 2025

Doctor Profile

Medical School Name
WASHINGTON STATE UNIVERSITY ELSON S FLOYD COLLEGE OF MEDICINE
Secondary Phone
5072842511
Graduation Year
2021 (5 years ago)
PAC ID
1850792078
Group Practice PAC ID
6507778255
Professional Enrollment ID
I20220805002941
Address ID
MN559050001RO200XXSWXX400

Contacts

Secure Messaging
nrandall1306587@ehrdirect.mayoclinicmsg.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness95
Years active:8State licenses:2Other names

321 OTOLARYNGOLOGY in WA

Provider Addresses for NICHOLAS REED RANDALL (MD)

  • 412 E Spokane Falls Blvd

    Spokane, WA 992022131

    Phone: (509) 358-7500

    Type: Location

  • East Spokane Falls Boulevard, Spokane, Spokane County, Washington, 99258, United States

    SPOKANE, WA 992022131

    Phone:

    Type: Mailing

  • 200 1ST ST SW

    ROCHESTER, MN 559050001

    Phone: (507) 284-2511

    Type: Mailing

  • PO BOX 860912

    MINNEAPOLIS, MN 554860912

    Phone: (507) 284-2511

    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: 2022-08-05

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
I20220805002941IOtolaryngologyMNTBD

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 99202)

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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: 6507778255View full group profile

Reviews

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Frequently asked questions

How do I look up NICHOLAS REED RANDALL (MD) by NPI?
Use NPI 1093229452 when you need to reference NICHOLAS REED RANDALL (MD) in forms, claims, or directories.
Is NICHOLAS REED RANDALL (MD)'s NPI currently valid?
The extract we use shows NICHOLAS REED RANDALL (MD) as active.
Does NICHOLAS REED RANDALL (MD) list a primary specialty?
If you are matching referrals, note Plastic Surgery within the Head & Neck (Otolaryngology) Physician for NICHOLAS REED RANDALL (MD). Clinical services aligned with this taxonomy classification.
What location metadata exists for NICHOLAS REED RANDALL (MD)?
The page summarizes Spokane, Washington for NICHOLAS REED RANDALL (MD); expand the address list for detail.
Is NICHOLAS REED RANDALL (MD) a real provider?
This page reflects official NPPES data for NPI 1093229452. Always confirm identity and privileges with the practice and licensing boards.

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