Individual provider Active NPI

Randolph W Hurley, MD

  • Hematology & Oncology Physician
  • St Paul, MN
National Provider Identifier
1033184239
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
34608 Issued in MN
Practice address
640 Jackson Street
MC 11503F
St Paul, MN 55101-2502
Phone
(651) 254-3448
Fax
(651) 254-3470
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 34608 MN Primary

Addresses

Primary practice location

640 Jackson Street
MC 11503F
St Paul, MN 55101-2502

Mailing address

8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516

Other identifiers 1

IdentifierTypeStateIssuer
142887000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100608000897 MN Practitioner - Hematology/Oncology 7719017334 Reassigns benefits to 2 organizations
I20100917000832 WI Practitioner - Hematology/Oncology 7719017334 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Wisconsin School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baldwin Area Medical Center IncGroup PAC ID 7911800586, 88 clinicians
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

1100 Bergslien St
Baldwin, WI 54002-2600
Phone (715) 684-1555

15350 English Ave
Apple Valley, MN 55124-6252
Phone (952) 431-8500

1654 Diffley Rd
Suite 100
Eagan, MN 55122-2237
Phone (651) 641-3900

205 Wabasha Ave S
Saint Paul, MN 55107-1805

233 Radio Dr
Woodbury, MN 55125-5805
Phone (952) 967-7616

2635 University Ave W
Suite 160
Saint Paul, MN 55114-1271
Phone (651) 254-3500

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 291-2848

4730 Chicago Ave S
Minneapolis, MN 55407-3570
Phone (952) 967-7485

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-3456

6845 Lee Ave N
Brooklyn Center, MN 55429-1717
Phone (763) 503-4400

8325 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (651) 702-5868

8450 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (651) 702-5300

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Regional Medical Center CurrentSince Mar 1, 2022 Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2002 Accepting new patients
Westfields Hospital, Inc Hematology & Oncology CurrentSince Jan 1, 2012 Accepting new patients
Westfields Hospital, Inc. CurrentSince Jan 1, 2012 Accepting new patients
Group Health, Inc. Current Accepting new patients
Park Nicollet Clinic CurrentSince Mar 24, 2014 Accepting new patients
St. Croix Regional Medical Center CurrentSince Mar 1, 2022 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Feb 1, 2017 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Feb 1, 2017 Accepting new patients
Baldwin Area Medical Center Inc. CurrentSince Aug 30, 2010 Accepting new patients
Baldwin Area Medical Center, Inc. CurrentSince Aug 30, 2010 Accepting new patients
Park Nicollet Clinic CurrentSince Mar 24, 2014 Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

8170 33rd Ave S
Stop 21110Q
Minneapolis, MN 55425

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

640 Jackson St
#11503F
Saint Paul, MN 55101
Phone (651) 254-3242

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

1500 Curve Crest Blvd W
Stillwater, MN 55082

927 Churchill St W
Stillwater, MN 55082
Phone (651) 430-4529

921 Greeley St S
West Lakeland, MN 55082

265 Griffin St E
Amery, WI 54001
Phone (715) 268-0301

1100 Bergslien St
Baldwin, WI 54002
Phone (715) 684-1111

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

235 E State St
St Croix Fls, WI 54024
Phone (715) 483-3221

216 S Adams St
St Croix Fls, WI 54024
Phone (715) 483-0426

Interoperability endpoints

  • Direct secure messaging: rhurley91679@excellian.direct.allina.com
  • Direct secure messaging: rhurley21823@direct.healthpartners.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1033184239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON STREET",
            "address_2": "MC 11503F",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3448",
            "fax_number": "651-254-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLEY",
        "first_name": "RANDOLPH",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MN",
            "license": "34608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142887000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Paul, MN

Sources for this page

Verify at the official NPI Registry.