NPIMap

Individual provider Active NPI

Randall Mark Kimball II, M.D.

  • Surgery Physician
  • Saratoga Springs, NY
National Provider Identifier
1972763977
Registry record updated Jun 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
271859 Issued in NY
Practice address
1 West Ave
Suite 125
Saratoga Springs, NY 12866-6045
Phone
(518) 693-4418
Fax
(518) 693-4481
NPI assigned
Jun 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 271859 NY Primary

Addresses

Primary practice location

1 West Ave
Suite 125
Saratoga Springs, NY 12866-6045

Mailing address

1 West Ave
Suite 125
Saratoga Springs, NY 12866-6045
Phone (518) 693-4418

Other identifiers 1

IdentifierTypeStateIssuer
03649552MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130829000633 NY Practitioner - General Surgery 1557526720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Albany Medical College of Union University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saratoga HospitalGroup PAC ID 6406740273, 353 clinicians

Practice addresses (Care Compare)

211 Church St
Saratoga Springs, NY 12866-1003
Phone (518) 583-8421

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
68.51 of 100Reported as group
Quality
56.19
Improvement activities
40
Cost
75.36

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy35
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
271859NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital Current Accepting new patients
Saratoga Hospital CurrentSince Aug 19, 2013 Accepting new patients
Saratoga Hospital CurrentSince Aug 19, 2013 Accepting new patients
Saratoga Hospital Past Accepting new patients

Locations

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

3044 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5800

1 West Ave
Ste 300
Saratoga Springs, NY 12866
Phone (518) 693-4699

1 West Ave
Ste 125
Saratoga Springs, NY 12866
Phone (518) 693-4418

Interoperability endpoints

  • Direct secure messaging: rkimball100135@albanymed.direct-ci.com

Organizations & group practices 4

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402012800000",
    "number": "1972763977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WEST AVE",
            "address_2": "SUITE 125",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128666045",
            "telephone_number": "518-693-4418",
            "fax_number": "518-693-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WEST AVE",
            "address_2": "SUITE 125",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128666045",
            "telephone_number": "518-693-4418",
            "fax_number": "518-693-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "RANDALL",
        "middle_name": "MARK",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2014-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "271859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03649552",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.