Dr Randall E Wiley, DC, MSN, ARNP is a medicare enrolled "Nurse Practitioner - Family" provider in Omak, Washington. He graduated from medical school in 2011 and has 13 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Dhhs Ihs Colville Service Unit, Omak Tribal Health Clinic and his current practice location is
617 Benton St, Omak, Washington. You can reach out to his office (for appointments etc.) via phone at
(509) 422-7416.
Dr Randall E Wiley is licensed to practice in Washington (license number N361159228) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1013029735.
Healthcare Provider's Profile
| Full Name | Dr Randall E Wiley |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 13 Years |
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| Location | 617 Benton St, Omak, Washington |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Randall E Wiley graduated from medical school in 2011
NPI Data:
- NPI Number: 1013029735
- Provider Enumeration Date: 08/31/2006
- Last Update Date: 05/05/2021
Medicare PECOS Information:
- PECOS PAC ID: 5597867465
- Enrollment ID: I20211217001285
Medical Identifiers
Medical identifiers for Dr Randall E Wiley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1013029735 | NPI | - | NPPES |
| 0104556249 | Other | VA | VA STATE LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | 0104556249 (Virginia) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | N361159228 (Washington) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Dhhs Ihs Colville Service Unit | 0941302509 | 4 |
| Omak Tribal Health Clinic | 1557458510 | 3 |
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. Dr Randall E Wiley allows following entities to bill medicare on his behalf.
| Provider Name | Dhhs Ihs Colville Service Unit |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1811091911
PECOS PAC ID: 0941302509
Enrollment ID: O20070228000304 |
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| Provider Name | Omak Tribal Health Clinic |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1639210370
PECOS PAC ID: 1557458510
Enrollment ID: O20071107000666 |
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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. Dr Randall E Wiley 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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Dr Randall E Wiley, DC, MSN, ARNP
Po Box 70,
Nespelem, WA 99155-0070
Ph: (509) 634-2900 | Dr Randall E Wiley, DC, MSN, ARNP
617 Benton St,
Omak, WA 98841-9636
Ph: (509) 422-7416 |
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