NICHOLAS REED RANDALL MD
NPI 1093229452
Otolaryngology - Plastic Surgery within the Head & Neck in Rochester, MN

Q: What is Nicholas Randall's NPI number?

The NPI number for Nicholas Randall is 1093229452. It was assigned to this individual provider in the NPPES registry on November 21, 2017.

Q: What is Nicholas Randall's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Plastic Surgery within the Head & Neck, with taxonomy code 207YX0007X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Randall was last updated on June 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 21, 2017PECOS EnrolledAccepts Medicare Assignment

200 1ST ST SW, ROCHESTER, MN 55905(507) 284-2511 Get Directions Write a Review

NPPES record last updated: June 30, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 12, 2025, Jul 22, 2022, Jun 18, 2021 and 2 more (5 updates tracked since 2017).

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About Nicholas Reed Randall Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICHOLAS REED RANDALL MD (NPI 1093229452) is an individual plastic surgery within the head & neck provider in Rochester, Minnesota, licensed in Minnesota (72135) and active in the NPI registry since November 2017. He is enrolled in Medicare PECOS, is affiliated with Mayo Clinic Hospital Rochester, and maintains a secondary practice location in Spokane.

NPPES Registry Identity

NPI1093229452

Entity TypeIndividualMale

Primary Taxonomy207YX0007X

Provider Legal NameNICHOLAS REED RANDALLCredential: MD

Location Address200 1ST ST SWRochester, MN 55905-0001

Mailing AddressPo Box 860912Minneapolis, MN 55486-0912 · (507) 284-2511

Phone(507) 284-2511

Sole ProprietorNo

Medical School CMSWashington State University Elson S Floyd College Of MedicineGraduated 2021

Enumeration DateNovember 21, 2017

Last NPPES UpdateJune 30, 20265 updates tracked since enumeration

NPPES CertifiedJune 30, 2026

✔ NPI 1093229452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngology · Plastic Surgery within the Head & NeckAllopathic & Osteopathic Physicians

Taxonomy Code207YX0007X

License✔ Licensed in MN · 72135

Definition

An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.

Also ListedOtolaryngologyTaxonomy 207Y00000X · License 31662 (MN), 72135 (MN), 344787 (NY)

200 1ST ST SW, Rochester, MN 55905

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Secondary Practice Location 1

Location 1412 E Spokane Falls BlvdSpokane, WA 99202-2131 · Phone (509) 358-7500

Other Identifiers 1

Medicaid201986937WAWA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicholas Reed Randall Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1850792078

PECOS Enrollment IDI20220805002941

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mayo Clinic Hospital Rochester

Acute Care Hospitals · Rochester, MN

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number240010

Location1216 Second Street SouthwestRochester, MN 55902 · Olmsted County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY LEASURE MD

Internal Medicine