Mr Randall Douglas Kelly, MHS, DMSC, PA-C is a medicare enrolled "Physician Assistant" provider in Hermiston, Oregon. His current practice location is
256 E Hurlburt Ave Ste 117, Hermiston, Oregon. You can reach out to his office (for appointments etc.) via phone at
(541) 303-3558.
Mr Randall Douglas Kelly is licensed to practice in Oregon (license number PA184529) 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 1922393974.
Healthcare Provider's Profile
| Full Name | Mr Randall Douglas Kelly |
|---|
| Gender | Male |
|---|
| Speciality | |
|---|
| Experience | Years |
|---|
| Location | 256 E Hurlburt Ave Ste 117, Hermiston, Oregon |
|---|
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Mr Randall Douglas Kelly attended and graduated from in
NPI Data:
- NPI Number: 1922393974
- Provider Enumeration Date: 06/16/2011
- Last Update Date: 01/19/2025
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Mr Randall Douglas Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1922393974 | NPI | - | NPPES |
| 0281857 | Other | WA | LABOR & INDUSTRIES |
| 2013576 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 184529 (Oregon) | Secondary |
| 2083A0300X | Preventive Medicine - Addiction Medicine | PA60205772 (Washington) | Secondary |
| 2083A0300X | Preventive Medicine - Addiction Medicine | PA184529 (Oregon) | Secondary |
| 363A00000X | Physician Assistant | PA60205772 (Washington) | Secondary |
| 363AM0700X | Physician Assistant - Medical | PA184529 (Oregon) | Secondary |
| 363A00000X | Physician Assistant | PA184529 (Oregon) | Primary |
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. Mr Randall Douglas Kelly 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 |
|---|
Mr Randall Douglas Kelly, MHS, DMSC, PA-C
5426 Road 68 Ste D253,
Pasco, WA 99301-5268
Ph: (541) 303-3558 | Mr Randall Douglas Kelly, MHS, DMSC, PA-C
256 E Hurlburt Ave Ste 117,
Hermiston, OR 97838-2443
Ph: (541) 303-3558 |
Reviews and Comments