Gannon B Randolph, MD in Bentonville, AR - Medicare Orthopedic Surgery

Gannon B Randolph, MD is a medicare enrolled "Orthopaedic Surgery - Orthopaedic Surgery Of The Spine" physician in Bentonville, Arkansas. He went to Oregon Health Sciences University School Of Medicine and graduated in 2000 and has 24 years of diverse experience with area of expertise as Orthopedic Surgery. He is a member of the group practice Ozark Orthopaedics, Pa, University Of Arkansas, Fands Physical Therapy, Inc and his current practice location is 1800 Se Moberly Ln, Bentonville, Arkansas. You can reach out to his office (for appointments etc.) via phone at (479) 521-2752.

Gannon B Randolph is licensed to practice in Arkansas (license number E5957) 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 1528173697.

Contact Information

	Gannon B Randolph, MD
	1800 Se Moberly Ln, Bentonville, AR 72712-7017
	(479) 521-2752
	(479) 521-4603

Map and Direction

Physician's Profile

Full Name	Gannon B Randolph
Gender	Male
Speciality	Orthopedic Surgery
Experience	24 Years
Location	1800 Se Moberly Ln, Bentonville, Arkansas
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:

Gannon B Randolph attended and graduated from Oregon Health Sciences University School Of Medicine in 2000

NPI Data:

NPI Number: 1528173697
Provider Enumeration Date: 08/20/2006
Last Update Date: 07/12/2021

Medicare PECOS Information:

PECOS PAC ID: 0941230619
Enrollment ID: I20090327000295

Medical Identifiers

Medical identifiers for Gannon B Randolph such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1528173697	NPI	-	NPPES
1176259001	Medicaid	AR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207X00000X	Orthopaedic Surgery	E5957 (Arkansas)	Secondary
207XS0117X	Orthopaedic Surgery - Orthopaedic Surgery Of The Spine	E5957 (Arkansas)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Northwest Medical Center-springdale	Springdale, AR	Hospital
Siloam Springs Regional Hospital	Siloam springs, AR	Hospital
Mercy Hospital Northwest Arkansas	Rogers, AR	Hospital
Uams Medical Center	Little rock, AR	Hospital
Washington Regional Medical Center	Fayetteville, AR	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Ozark Orthopaedics, Pa	2860477189	49
University Of Arkansas	4082528955	1098
Fands Physical Therapy, Inc	7810898459	80

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. Gannon B Randolph allows following entities to bill medicare on his behalf.

Entity Name	Mercy Health Northwest Arkansas Communities
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1265490916 PECOS PAC ID: 0648177873 Enrollment ID: O20031216000788

Entity Name	University Of Arkansas For Medical Sciences
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1588654016 PECOS PAC ID: 4082528955 Enrollment ID: O20031219000706

Entity Name	Ozark Orthopaedics, Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1649210584 PECOS PAC ID: 2860477189 Enrollment ID: O20040621001974

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. Gannon B Randolph 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
Gannon B Randolph, MD 3317 N Wimberly Dr, Fayetteville, AR 72703-4056 Ph: (479) 521-2752	Gannon B Randolph, MD 1800 Se Moberly Ln, Bentonville, AR 72712-7017 Ph: (479) 521-2752

Reviews and Comments

Orthopaedic Surgery Doctors in Bentonville, AR

Dr. Christopher P Dougherty, D.O. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1504 Se 28th St, Bentonville, AR 72712 Phone: 479-273-1111 Fax: 479-273-1255
Rodger C Dickinson Jr., M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 1504 Se 28th St, Bentonville, AR 72712 Phone: 479-273-1111 Fax: 479-273-1255
Brandon Lee Morris, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1504 Se 28th St, Bentonville, AR 72712 Phone: 479-273-1111
Charles Irving Jones Iii, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 2900 Medical Center Pkwy Ste 300, Bentonville, AR 72712 Phone: 479-553-3360 Fax: 479-553-1911
Dr. James Marshall Mckenzie, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 1504 Se 28th St, Bentonville, AR 72712 Phone: 479-273-1111 Fax: 479-273-1255
Dr. Robert Angus Macleod, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1800 Se Moberly Ln, Ste 4, Bentonville, AR 72712 Phone: 479-715-6600 Fax: 479-521-4603

Gannon B Randolph, MD - Medicare Orthopedic Surgery in Bentonville, AR