Individual provider Active NPI

Kirsten Randall, D.O.

  • Anesthesiology Physician
  • Durham, NC
National Provider Identifier
1689645822
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
20A 10035 Issued in CA
Practice address
2100 Erwin Rd
Dumc 3094
Durham, NC 27705-3941
Phone
(623) 640-4624
NPI assigned
Jan 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2009-00663 NC
Anesthesiology Physician 207L00000X 20A 10035 CA Primary

Addresses

Primary practice location

2100 Erwin Rd
Dumc 3094
Durham, NC 27705-3941

Mailing address

2100 Erwin Rd
Dumc 3094
Durham, NC 27705-3941
Phone (623) 640-4624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20240816002423 WA Practitioner - Anesthesiology 3971636457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Arizona College of Osteopathic Medicine Mid Western University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Wa Anesthesia Services, PCGroup PAC ID 9335298884, 85 clinicians

Practice addresses (Care Compare)

1211 24TH St
Anacortes, WA 98221-2562
Phone (914) 491-9495

Hospital & facility affiliations

  • Island Hospital Hospital, Anacortes, WA, CCN 500007

Merit-based Incentive Payment System (MIPS)

Final score
74.5 of 100Reported as group
Quality
70
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A 10035CAMDAnesthesiology Physician
2009-00663NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Wa Anesthesia Services, P.C. Anesthesiology CurrentSince Jun 13, 2024 Accepting new patients
University Hospitals Medical Group Inc Anesthesiology PastSince Jun 20, 2010 Accepting new patients

Locations

450 Mamaroneck Ave
Ste 201
Harrison, NY 10528
Phone (877) 476-6642

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1689645822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 ERWIN RD",
            "address_2": "DUMC 3094",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053941",
            "telephone_number": "623-640-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 ERWIN RD",
            "address_2": "DUMC 3094",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053941",
            "telephone_number": "623-640-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "KIRSTEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2009-00663",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A 10035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.