Randall A Bostrom, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

30066 Issued in MN

Practice address

331 Highway 65 S
Mora, MN 55051-1899

Phone

(320) 679-1313

Fax

(320) 225-3141

NPI assigned

Mar 25, 2006

Last updated

Jul 13, 2026By 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

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Welia Health

  • Critical Access Hospital
  • Mora, MN
  • NPI 1528031390
  Medicare reassignment NPD
• Welia Health

  • Rural Health Clinic/Center
  • Pine City, MN
  • NPI 1992012207
  NPD

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396705083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "address_2": "MR 10809",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-4813",
            "fax_number": "612-262-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 HIGHWAY 65 S",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511899",
            "telephone_number": "320-679-1313",
            "fax_number": "320-225-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTROM",
        "first_name": "RANDALL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "30066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bio-Medical Applications of Minnesota, Inc. (Fresenius Kidney Care Mora Dialysis)
• Kaitlyn Blanchard, PHARM.D.
• Susan Dorothy Blom, PH.D.
• Mary Kay Borgstrom, RN, PMHCNS-BC
• Brenda Ann Bosaaen
• Shelley Bragelman, PT
• Lori Braiedy, MA CCC-SLP
• Sadie Briana Broekemeier, LPCC
• Joseph John Buckley, CRNA
• Aimee Burk

• Family Medicine Physician in Mora, MN
• Providers in Mora, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.