NPIMap

Individual provider Active NPI

Randy J. Rice, M.D.

  • Family Medicine Physician
  • Moose Lake, MN
National Provider Identifier
1083652275
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34715 Issued in MN
Practice address
4570 Cty. Hwy. 61
Moose Lake, MN 55767
Phone
(218) 485-4491
Fax
(218) 485-4724
NPI assigned
Jun 2, 2006
Last updated
Dec 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34715 MN Primary

Addresses

Primary practice location

4570 Cty. Hwy. 61
Moose Lake, MN 55767

Mailing address

4570 Cty. Hwy. 61
Moose Lake, MN 55767
Phone (218) 485-4491

Other identifiers 1

IdentifierTypeStateIssuer
326880200MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031202000089 MN Practitioner - Family Practice 3577468719 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duluth Graduate Medical Education Council IncGroup PAC ID 4385545953, 32 clinicians

Practice addresses (Care Compare)

330 N 8TH Ave E
Duluth, MN 55805-2024
Phone (218) 723-1112

4570 Cty Hwy 61
Moose Lake, MN 55767-9401
Phone (218) 485-4491

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake View Memorial Hospital, Inc CurrentSince Dec 3, 2023 Accepting new patients
Essentia Health Moose Lake CurrentSince Aug 1, 2020 Accepting new patients
Essentia Health Moose Lake CurrentSince Aug 1, 2020 Accepting new patients
Cook County Hospital District CurrentSince Nov 30, 2023 Accepting new patients
Gateway Family Health Clinic, LTD. Family Medicine CurrentSince Jul 31, 2006 Accepting new patients
Gateway Family Health Clinic, LTD. Current Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients
Duluth Graduate Medical Education Council Inc Family Medicine CurrentSince Mar 20, 2023 Accepting new patients
Lake View Memorial Hospital, Inc. CurrentSince Dec 3, 2023 Accepting new patients
Altru Health System Past Accepting new patients
Gateway Family Health Clinic, LTD. Family Medicine Past Accepting new patients
Augustana Mercy Care Center LLC Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

330 N 8th Ave E
Duluth, MN 55805
Phone (218) 529-9122

515 5th Ave W
Grand Marais, MN 55604
Phone (218) 387-3040

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

707 Lundorff Dr
#1
Sandstone, MN 55072
Phone (320) 245-2250

325 11th Ave
Two Harbors, MN 55616
Phone (218) 834-5520

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDGJBA
  • Direct secure messaging: randy.rice@gfhc.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Gateway Family Health Clinic, LTD.Sandstone, MN, CCN 243859 Rural health clinic 5% Or Greater Direct Ownership Interest (9.09%)
General Partnership Interest (9.09%)
Corporate Director
W-2 Managing Employee (9.09%)		 Jan 1, 2008
Jan 1, 2008
Jul 31, 2006
Jan 1, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1083652275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4570 CTY. HWY. 61",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "55767",
            "telephone_number": "218-485-4491",
            "fax_number": "218-485-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 CTY. HWY. 61",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "55767",
            "telephone_number": "218-485-4491",
            "fax_number": "218-485-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICE",
        "first_name": "RANDY",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "34715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "326880200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moose Lake, MN

Sources for this page

Verify at the official NPI Registry.