RANDALL A BOSTROM MD
NPI 1396705083
Family Medicine in Mora, MN

Q: What is Randall Bostrom's NPI number?

The NPI number for Randall Bostrom is 1396705083. It was assigned to this individual provider in the NPPES registry on March 25, 2006.

Q: What is Randall Bostrom's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Randall Bostrom was last updated on July 13, 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 March 25, 2006PECOS Enrolled

331 HIGHWAY 65 S, MORA, MN 55051(320) 679-1313(320) 225-3141 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Randall A Bostrom Md NPPES

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

RANDALL A BOSTROM MD (NPI 1396705083) is an individual family medicine provider in Mora, Minnesota, licensed in Minnesota (30066) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396705083

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameRANDALL A BOSTROMCredential: MD

Location Address331 HIGHWAY 65 SMora, MN 55051-1899

Mailing AddressPo Box 43, Mr 10809Minneapolis, MN 55440-0043 · (612) 262-4813 · Fax (612) 262-4194

Phone(320) 679-1313

Fax(320) 225-3141

Sole ProprietorNo

Enumeration DateMarch 25, 2006

Last NPPES UpdateJuly 13, 2026

✔ NPI 1396705083 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MN · 30066

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.

331 HIGHWAY 65 S, Mora, MN 55051

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Randall A Bostrom Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Randall Bostrom reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Welia Health

0.3 mi

Critical Access

301 HIGHWAY 65 S
Mora, MN 55051

Reassigned Medicare billing, Minnesota enrollment
126 clinicians in this Medicare group

NPI 1528031390 (320) 679-1212

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55051 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

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.

Other Providers at the Same Location NPPES 8

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

RENEE L COLEMAN PAC

Physician Assistant