Brent Randall, is a medicare enrolled "Occupational Therapist" provider in Kimberly, Idaho. His current practice location is
302 Garnet Dr, Kimberly, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 731-9799.
Brent Randall is licensed to practice in Idaho (license number OT-556) 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 1497913123.
Healthcare Provider's Profile
| Full Name | Brent Randall |
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| Gender | Male |
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| Speciality | Occupational Therapist |
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| Location | 302 Garnet Dr, Kimberly, Idaho |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1497913123
- Provider Enumeration Date: 05/29/2008
- Last Update Date: 05/29/2008
Medicare PECOS Information:
- PECOS PAC ID: 5294986105
- Enrollment ID: I20121126000632
Medical Identifiers
Medical identifiers for Brent Randall such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1497913123 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | OT-556 (Idaho) | 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. Brent Randall allows following entities to bill medicare on his behalf.
| Provider Name | Valley Therapy Services, Inc. |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1639343270
PECOS PAC ID: 2567528557
Enrollment ID: O20120716000380 |
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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. Brent Randall 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 |
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Brent Randall,
414 N Lincoln Ave Ste 5,
Jerome, ID 83338-2300
Ph: () - | Brent Randall,
302 Garnet Dr,
Kimberly, ID 83341-1931
Ph: (208) 731-9799 |
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