Randy I Cooper, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

30432 Issued in AZ

Practice address

7362 W Thunderbird Rd Ste 103
Peoria, AZ 85381-5028

Phone

(480) 610-6152

Fax

(480) 610-6189

NPI assigned

Sep 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Specialty

NephrologyAlso: Internal Medicine

Education

Ohio State University College of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Kidney Institute Vascular Center LLCGroup PAC ID 4183801350, 6 clinicians

Southwest Kidney Institute PLCGroup PAC ID 8224930987, 100 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Phoenix Dialysis Center Dialysis facility, Phoenix, AZ, CCN 032611

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: randy.cooper.3@2697.direct.athenahealth.com
• Direct secure messaging: randy.cooper.2@2697.direct.athenahealth.com
• Direct secure messaging: randy.cooper.1@2697.direct.athenahealth.com

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.

• Southwest Kidney Institute Vascular Center LLC

  • Nephrology Physician
  • Tempe, AZ
  • NPI 1134426893
  Medicare reassignment Care Compare group NPD Authorized official
• Southwest Kidney Institute, PLC

  • Nephrology Physician
  • Tempe, AZ
  • NPI 1659316008
  Medicare reassignment Care Compare group
• Ski Ambulatory Surgical Centers, LLC

  • Ambulatory Surgical Clinic/Center
  • Peoria, AZ
  • NPI 1023567260
  Medicare reassignment NPD
• Ski Ambulatory Surgical Centers, LLC

  • Ambulatory Surgical Clinic/Center
  • Tempe, AZ
  • NPI 1275077414
  Medicare reassignment NPD
• Southwest Kidney Institute Scottsdale LLC

  • Nephrology Physician
  • Phoenix, AZ
  • NPI 1902231012
  Medicare reassignment NPD
• Southwest Kidney Dialysis, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Tempe, AZ
  • NPI 1134178007
  NPD (past)

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

• Southwest Kidney Davita Dialysis Partners LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Phoenix, AZ
  • NPI 1013190792

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1154316495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 E WARNER RD",
            "address_2": "SUITE 101",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852843494",
            "telephone_number": "480-610-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7362 W THUNDERBIRD RD STE 103",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815028",
            "telephone_number": "480-610-6152",
            "fax_number": "480-610-6189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 E University Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852818401",
            "country_code": "US",
            "telephone_number": "480-610-6152",
            "fax_number": "480-610-6189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "RANDY",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "30432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "722464",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany L Cooke, PA-C
• Kristin Lee Coolidge, FNP-C
• Nathan David Coons, PHARM D.
• Joel Robin Cooper, D.O.
• Kristin Cooper, RPH
• Steven Michael Cooper, DMD
• Cooperman Family Dentistry PLLC
• Blair W. Copp, DC
• Copper Sky Dental, PLLC
• Gregory J Cordes, PA

• Nephrology Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Nephrology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.