Collin Douglas Randall, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PT961 Issued in WY

Practice address

4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367

Phone

(206) 616-4001

NPI assigned

Aug 13, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sound Physicians of Wyoming LLCGroup PAC ID 8325214828, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Wyoming Medical Center Hospital, Casper, WY, CCN 530012
• Sagewest Health Care Hospital, Riverton, WY, CCN 530008

Merit-based Incentive Payment System (MIPS)

Final score

80.9 of 100Reported as group

Quality

68.13

Promoting interoperability

99

Improvement activities

40

Cost

69.04

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Sound Physicians of Wyoming, LLC

  • Hospitalist Physician
  • Casper, WY
  • NPI 1982982708
  Medicare reassignment Care Compare group
• Banner Health Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Ogallala, NE
  • NPI 1154687812
  NPD

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

• Riverton Memorial Hospital LLC

  • Rural Acute Care Hospital
  • Lander, WY
  • NPI 1245337286
  Care Compare affiliation
• Wyoming Medical Center Inc

  • General Acute Care Hospital
  • Casper, WY
  • NPI 1346332954
  Care Compare affiliation

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1508477555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056367",
            "telephone_number": "206-616-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "COLLIN",
        "middle_name": "DOUGLAS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-13",
        "last_updated": "2021-11-23",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "PT961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Dawn Ranchigoda, LICSW
• Suresh Ranchod, D.O.
• Maude Rancourt, M.D., F.R.C.S.C.
• Natalie Rand
• Cameron Lindsey Randall
• Elizabeth Randall, LMHC
• Evan Randall, M.D.
• Jacqueline Ann Randall, PSY.D.
• Maureen Elizabeth Randall, PA-C
• Tim Randall

• Medical Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.