Individual provider Active NPI

Randall L Breau, M.D.

  • MOHS-Micrographic Surgery Physician
  • Little Rock, AR
National Provider Identifier
1699804138
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
E1230 Issued in AR
Practice address
9601 Baptist Health Dr Ste 860
Little Rock, AR 72205-6375
Phone
(501) 975-7455
Fax
(501) 975-3631
NPI assigned
Mar 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X E1230 AR
Procedural Dermatology Physician 207NS0135X E1230 AR
MOHS-Micrographic Surgery Physician 207ND0101X E1230 AR Primary

Addresses

Primary practice location

9601 Baptist Health Dr Ste 860
Little Rock, AR 72205-6375

Mailing address

4261 Stockton Drive Suite Ll100
North Little Rock, AR 72117
Phone (501) 975-7456

Other practice location 1

1604 E Moore Ave
Searcy, AR 72143-4633
Phone (501) 268-1500

Other practice location 2

2645 Highway 25B
Heber Springs, AR 72543-6305
Phone (501) 362-3100

Other practice location 3

15506 Highway 5 Ste A
Cabot, AR 72023-7695
Phone (501) 941-3101

Other practice location 4

4261 Stockton Dr Ste 200
North Little Rock, AR 72117-2962
Phone (501) 791-7546

Other identifiers 1

IdentifierTypeStateIssuer
131705001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20070810000687 AR Practitioner - Dermatology 7416048095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Louisiana State University School of Medicine in New Orleans, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Dermatology PLLCGroup PAC ID 2466418470, 20 clinicians

Practice addresses (Care Compare)

9601 Baptist Health Dr
Suite 860
Little Rock, AR 72205-6375
Phone (501) 975-7455

Merit-based Incentive Payment System (MIPS)

Final score
81.96 of 100Reported as group
Quality
58.71
Promoting interoperability
99
Improvement activities
40
Cost
81.98

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision362
Removal of tissue13
Removal of skin lesions1124
Removal of skin cancer1154
Removal or shaving of skin growth28
Skin biopsy456

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E1230ARMDMOHS-Micrographic Surgery Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1699804138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4261 STOCKTON DRIVE SUITE LL100",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "72117",
            "telephone_number": "501-975-7456",
            "fax_number": "501-978-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 BAPTIST HEALTH DR STE 860",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056375",
            "telephone_number": "501-975-7455",
            "fax_number": "501-975-3631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1604 E Moore Ave",
            "address_purpose": "LOCATION",
            "city": "Searcy",
            "state": "AR",
            "postal_code": "721434633",
            "country_code": "US",
            "telephone_number": "501-268-1500",
            "fax_number": "501-268-1505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2645 Highway 25B",
            "address_purpose": "LOCATION",
            "city": "Heber Springs",
            "state": "AR",
            "postal_code": "725436305",
            "country_code": "US",
            "telephone_number": "501-362-3100",
            "fax_number": "501-362-3105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15506 Highway 5 Ste A",
            "address_purpose": "LOCATION",
            "city": "Cabot",
            "state": "AR",
            "postal_code": "720237695",
            "country_code": "US",
            "telephone_number": "501-941-3101",
            "fax_number": "501-941-3015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4261 Stockton Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "North Little Rock",
            "state": "AR",
            "postal_code": "721172962",
            "country_code": "US",
            "telephone_number": "501-791-7546",
            "fax_number": "501-753-1992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREAU",
        "first_name": "RANDALL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AR",
            "license": "E1230",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AR",
            "license": "E1230",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AR",
            "license": "E1230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131705001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.