Randolph Charles Fish, D.P.M.

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

91-1813864 Issued in WA

Practice address

915 So. 76TH St.
Tacoma, WA 98408-2902

Phone

(253) 584-9530

Fax

(360) 427-2769

NPI assigned

Nov 10, 2005

Last updated

Apr 8, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Temple University School of Podiatric Medicine, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Harbors Home Health / Hospice Home health agency, Hoquiam, WA, CCN 507020
• Grays Harbor Community Hospital Hospital, Aberdeen, WA, CCN 500031
• Capital Medical Center Hospital, Olympia, WA, CCN 500139
• Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
• Summit Pacific Medical Center Hospital, Elma, WA, CCN 501304

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Foundation Foot and Ankle Specialists PLLC

  • Foot & Ankle Surgery Podiatrist
  • Auburn, WA
  • NPI 1265099949

  Primary Podiatric Medicine

  NPD (past)

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

• Grays Harbor Community Hospital

  • General Acute Care Hospital
  • Aberdeen, WA
  • NPI 1154378859
  Care Compare affiliation
• Grays Harbor County Public Hospital District No 1

  dba Summit Pacific Medical Center

  • Critical Access Hospital
  • Elma, WA
  • NPI 1740211028
  Care Compare affiliation
• Harbors Home Health & Hospice

  • Home Health Agency
  • Hoquiam, WA
  • NPI 1699777276
  Care Compare affiliation
• Multicare Health System

  dba Tacoma General Allenmore

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1366556227
  Care Compare affiliation
• Multicare Health System

  dba MultiCare Capital Medical Center

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1841258639
  Care Compare affiliation

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460073600000",
    "number": "1063493559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 SO. 76TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984082902",
            "telephone_number": "253-584-9530",
            "fax_number": "360-427-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 SO. 76TH ST.",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984082902",
            "telephone_number": "253-584-9530",
            "fax_number": "360-427-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "RANDOLPH",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2016-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "WA",
            "license": "91-1813864",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "WA",
            "license": "PO00000297",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2041494",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2041490",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Joseph Firth, NP-C
• Carrie Lynn Fischer, LCSW
• Joan Lorraine Fischer, ARNP CNM
• Kristin Sweet Fischer, MA, LMFT
• Charity Lyn Fiscus, LPN
• Cameron Y Fisher, CDP
• Christine Ann Fisher, RNC
• Dona-Nalani Sumiko Fisher, LMP
• Eugena Fisher
• Gregory R Fisher, DDS

• Primary Podiatric Medicine Podiatrist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Primary Podiatric Medicine Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.