DR. RANDALL ALAN SWAIN MD
NPI 1255395273
Family Medicine in Charleston, WV

Active since April 14, 2006PECOS EnrolledAccepts Medicare Assignment
90.11/100
CMS Quality Rating
4602 MACCORKLE AVE SE, CHARLESTON, WV 25304(304) 925-4777(304) 925-4780 Get Directions Write a Review

NPPES record last updated: January 30, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Randall Alan Swain Md NPPES

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

DR. RANDALL ALAN SWAIN MD (NPI 1255395273) is an individual family medicine provider in Charleston, West Virginia, licensed in West Virginia (16120) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Charleston Area Medical Center, and is a graduate of West Virginia University School Of Medicine (1987).

NPPES Registry Identity

NPI1255395273
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. RANDALL ALAN SWAINCredential: MD
Location Address4602 MACCORKLE AVE SECharleston, WV 25304-1848
Mailing Address415 Morris St, Suite 304Charleston, WV 25301-1842 · (304) 388-7783 · Fax (304) 388-7788
Fax(304) 925-4780
Sole ProprietorNo
Medical School CMSWest Virginia University School Of MedicineGraduated 1987
Enumeration DateApril 14, 2006
Last NPPES UpdateJanuary 30, 2026
NPPES CertifiedJanuary 30, 2026
NPI 1255395273 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in WV · 16120
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedEmergency MedicineTaxonomy 207P00000X · License 16120 (WV)
4602 MACCORKLE AVE SE, Charleston, WV 25304

Other Identifiers 3

Medicaid0042952-000WV
OtherP00058528Railroad Medicare
Medicaid0042952000WV

Accepted 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

Dr. Randall Alan Swain 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 ID8729986658
PECOS Enrollment IDI20031230000073
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.

Areas of Expertise CMS Part B claims 21

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit, 20-29 minutes 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
216 services196 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426
An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.
132 services122 patients
Established patient office or other outpatient visit, 20-29 minutes 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
127 services98 patients
Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
120 services12 patients
Detection test by immunoassay with direct visual observation for influenza virus 87804
This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
102 services51 patients
Established patient office or other outpatient visit, 30-39 minutes 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
101 services98 patients

Hospital Affiliations CMS Care Compare 2

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

Charleston Area Medical Center

Acute Care Hospitals · Charleston, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510022
Location501 Morris StreetCharleston, WV 25301 · Kanawha County
Emergency services Birthing friendly

Thomas Memorial Hospital

Acute Care Hospitals · South Charleston, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510029
Location4605 Maccorkle Avenue SWSouth Charleston, WV 25309 · Kanawha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25304 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

90.11/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality66.96
Promoting Interoperability100
Improvement Activities40

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.

Internal Medicine
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304
Emergency Medicine
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304
Clinic/Center (Urgent Care)
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304
Clinic/Center (Federally Qualified Health Center (FQHC))
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304
Family Medicine
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304
Family Medicine
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304
Internal Medicine
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304
Family Medicine
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304

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 Randall Swain's NPI number?

The NPI number for Randall Swain is 1255395273. It was assigned to this individual provider in the NPPES registry on April 14, 2006.

Where is Randall Swain located?

Randall Swain practices at 4602 Maccorkle Ave SE, Charleston, WV 25304. The listed phone number is (304) 925-4777.

What is Randall Swain's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Randall Swain enrolled in Medicare?

Yes. Randall Swain 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.

What insurance does Randall Swain accept?

Health plans from CareSource and Highmark Blue Cross Blue Shield West Virginia list Randall Swain 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.

Is Randall Swain affiliated with any hospitals?

According to CMS data, Randall Swain is affiliated with Charleston Area Medical Center and Thomas Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Randall Swain was last updated on January 30, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.