KYLIE GAGNON RANDALL OT
NPI 1114428133
Occupational Therapist in Broadus, MT

Active since February 25, 2018Accepts Medicare Assignment
79.6/100
CMS Quality Rating
104 N TRAUTMAN AVE, BROADUS, MT 59317(406) 436-2646 Get Directions Write a Review

NPPES record last updated: June 15, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 15, 2021, Oct 23, 2019, Sep 24, 2019 and 1 more (4 updates tracked since 2018).

About Kylie Gagnon Randall Ot NPPES

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

KYLIE GAGNON RANDALL OT (NPI 1114428133) is an individual occupational therapist in Broadus, Montana and active in the NPI registry since February 2018. She maintains a secondary practice location in Bozeman and is a graduate of Other (2017).

NPPES Registry Identity

NPI1114428133
Entity TypeIndividualFemale
Primary Taxonomy225X00000X
Provider Legal NameKYLIE GAGNON RANDALLCredential: OT
Location Address104 N TRAUTMAN AVEBroadus, MT 59317-7504
Mailing Address3400 Stucky RdBozeman, MT 59718-7557 · (406) 581-8300
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateFebruary 25, 2018
Last NPPES UpdateJune 15, 20214 updates tracked since enumeration
NPPES CertifiedJune 15, 2021
✔ NPI 1114428133 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
Definition
An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
104 N TRAUTMAN AVE, Broadus, MT 59317

Other Names 1

Former Name (1)Kylie Ann Gagnon Ot

Secondary Practice Location 1

Location 11450 Ellis St Ste 201Bozeman, MT 59715-8813 · Phone (406) 556-9110

Other Identifiers 1

Other5456MT · Ot Licence

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kylie Gagnon Randall Ot 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 ID840551719
PECOS Enrollment IDI20180312000319

Medicare Billing Reassignments

2

Medicare enrollment records show Kylie Randall reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Skilled Nursing Facility
104 N. TRAUTMAN STREET, BOX 719
Broadus, MT 59317
  • Reassigned Medicare billing, Montana enrollment
  • 5 clinicians in this Medicare group
Orthopaedic Surgery
3400 LARAMIE DR
Bozeman, MT 59718
  • Reassigned Medicare billing, Montana enrollment
  • 61 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

79.6/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality59.43
Promoting Interoperability98
Improvement Activities40
Cost74.25

Other Providers at the Same Location NPPES

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

Physical Therapist
104 N TRAUTMAN AVE
BROADUS, MT 59317

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kylie Randall's NPI number?

The NPI number for Kylie Randall is 1114428133. It was assigned to this individual provider in the NPPES registry on February 25, 2018. The provider is also known as Kylie Ann Gagnon Ot.

Where is Kylie Randall located?

Kylie Randall practices at 104 N Trautman Ave, Broadus, MT 59317. The listed phone number is (406) 436-2646.

What is Kylie Randall's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

Is Kylie Randall enrolled in Medicare?

Yes. Kylie Randall is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kylie Randall's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kylie Randall reassigns Medicare benefits to 2 organizations: Powder River County (Broadus, MT) and Bridger Orthopedics And Sports Medicine, PC (Bozeman, MT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kylie Randall's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kylie Randall accept?

Health plans from Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, PacificSource Health Plans and Providence Health Plan list Kylie Randall as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kylie Randall was last updated on June 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.