Randall J Bolar, MD in Detroit Lakes, MN

Randall J Bolar, MD is a medicare enrolled "Surgery" physician in Detroit Lakes, Minnesota. His current practice location is 1027 Washington Ave, Detroit Lakes, Minnesota. You can reach out to his office (for appointments etc.) via phone at (218) 847-5611.

Randall J Bolar is licensed to practice in Minnesota (license number 36945) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1558323246.

Contact Information

	Randall J Bolar, MD
	1027 Washington Ave, Detroit Lakes, MN 56501-3409
	(218) 847-5611
	(218) 847-0881

Map and Direction

Physician's Profile

Full Name	Randall J Bolar
Gender	Male
Speciality	Surgery
Location	1027 Washington Ave, Detroit Lakes, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1558323246
Provider Enumeration Date: 04/06/2006
Last Update Date: 12/23/2015

Medicare PECOS Information:

PECOS PAC ID: 3274560396
Enrollment ID: I20120423000743

Medical Identifiers

Medical identifiers for Randall J Bolar such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1558323246	NPI	-	NPPES
1515147	Medicaid	TN
TN0125	Other	TN	AMERICHOICE
203500913011	Other	TN	TRICARE
000000069481	Other	KY	ANTHEM BC
10802394	Other		CAQH
1558323246	Medicaid	MN
01281517	Other	TN	AMERIGROUP
4221186	Other	TN	BCBS
64357130	Medicaid	KY
7774037	Other	KY	AETNA
3338849	Medicaid	TN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	34949 (Tennessee)	Secondary
208600000X	Surgery	36945 (Minnesota)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Randall J Bolar allows following entities to bill medicare on his behalf.

Entity Name	Innovis Health Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1659617504 PECOS PAC ID: 9931298155 Enrollment ID: O20080115000831

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Randall J Bolar is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Randall J Bolar, MD 1027 Washington Ave, Detroit Lakes, MN 56501-3409 Ph: (218) 847-5611	Randall J Bolar, MD 1027 Washington Ave, Detroit Lakes, MN 56501-3409 Ph: (218) 847-5611

Reviews and Comments

Surgery Doctors in Detroit Lakes, MN

George A Portilla, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-847-5611 Fax: 218-847-0881
Mitchell B Goldstein, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1245 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-846-2000 Fax: 218-846-2114
Shang-yee S Yeh, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-844-2347

Randall J Bolar, MD - Medicare Surgery in Detroit Lakes, MN