Randal Lee Wraalstad, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

P152 Issued in ID

Practice address

762 N College Rd Ste a
Twin Falls, ID 83301-5392

Phone

(208) 814-7150

Fax

(208) 814-7170

NPI assigned

May 24, 2005

Last updated

Nov 5, 2024By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in ID

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

California School of Podiatric Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health of Idaho Home health agency, Twin Falls, ID, CCN 137100
• St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
• St Luke's Jerome Hospital, Jerome, ID, CCN 131310

Merit-based Incentive Payment System (MIPS)

Final score

85.09 of 100Reported as group

Quality

77.1

Promoting interoperability

100

Improvement activities

40

Cost

73.19

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• St Luke's Clinic LLC

  dba St Lukes Clinic - Magic Valley/Jerome

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1790718229
  Medicare reassignment Care Compare group NPD
• Twin Falls Orthopedics, PLLC

  • Specialist
  • Twin Falls, ID
  • NPI 1659316875
  NPD (past)

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

• Guardian Home Care, Inc.

  dba Enhabit Home Health of Idaho

  • Home Health Agency
  • Twin Falls, ID
  • NPI 1801884374
  Care Compare affiliation
• St Luke's Magic Valley Regional Medical Center LTD

  dba St Luke's Jerome

  • Critical Access Hospital
  • Jerome, ID
  • NPI 1366874877
  Care Compare affiliation
• St. Luke's Magic Valley Regional Medical Center, LTD.

  dba St Lukes Magic Valley - Air Ambulance

  • General Acute Care Hospital
  • Twin Falls, ID
  • NPI 1932154705
  Care Compare affiliation

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1255334066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "fax_number": "208-814-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 N COLLEGE RD STE A",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015392",
            "telephone_number": "208-814-7150",
            "fax_number": "208-814-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAALSTAD",
        "first_name": "RANDAL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ID",
            "license": "P152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804243900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRR",
            "identifier": "P00899555",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyrsten M Wooldridge, LD
• McKay Beard Woolstenhulme, MSW, LMSW
• Donald Paul Workman, MD
• Rebecca Worst, LCSW
• Richard Worst, M.D.
• Tanner Wray, DC
• Michael Andrew Wren, DPT, PT
• Jolene M Wright Bostock, MS, CCC-SLP/L
• Wright Physical Therapy Limited Partnership
• Wright Physical Therapy, LLC

• Foot & Ankle Surgery Podiatrist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Foot & Ankle Surgery Podiatrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.