Randall James Kelley, DMD - Medicare Dentist in Provo, UT

Randall James Kelley, DMD is a medicare enrolled "Dentist - General Practice" provider in Provo, Utah. His current practice location is 275 N 500 W, Suite C, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 374-5768.

Randall James Kelley is licensed to practice in California (license number 33052) 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 1538387154.

Contact Information

Randall James Kelley, DMD
275 N 500 W, Suite C,
Provo, UT 84601-3006
(801) 374-5768
(801) 375-3598

Map and Direction




Healthcare Provider's Profile

Full NameRandall James Kelley
GenderMale
SpecialityDentist - General Practice
Location275 N 500 W, Provo, Utah
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1538387154
  • Provider Enumeration Date: 04/20/2007
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 7618372749
  • Enrollment ID: I20210826003123

Medical Identifiers

Medical identifiers for Randall James Kelley such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1538387154NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223G0001XDentist - General Practice 33052 (California)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. Randall James Kelley 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 AddressPractice Location Address
Randall James Kelley, DMD
9255 Maison Dr,
Sandy, UT 84093-2427

Ph: (650) 218-0069
Randall James Kelley, DMD
275 N 500 W, Suite C,
Provo, UT 84601-3006

Ph: (801) 374-5768

Reviews and Comments


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Dr. Louis A Erickson, DDS
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Phone: 801-374-5100    Fax: 801-375-2464
Dr. Paul Henry Rogers, D.D.S.
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Phone: 801-361-7131    
Dr. Gary M Hulet, DMD
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Practice Location: 777 N 500 W, Suite 101b, Provo, UT 84601
Phone: 801-375-1275    Fax: 801-375-1294

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.