RANDALL PAUL BENNETT MD
NPI 1619907953
Otolaryngology in Puyallup, WA
About Randall Paul Bennett Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RANDALL PAUL BENNETT MD (NPI 1619907953) is an individual otolaryngology provider in Puyallup, Washington, licensed in Washington (MD22922) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Randall Paul Bennett Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Randall Bennett reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Puyallup, WA 98374
- Reassigned Medicare billing, Washington enrollment
- 589 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98374 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 18
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Bennett's NPI number?
The NPI number for Randall Bennett is 1619907953. It was assigned to this individual provider in the NPPES registry on July 3, 2006.
Where is Randall Bennett located?
Randall Bennett practices at 104 27th Ave SE, Puyallup, WA 98374. The listed phone number is (253) 770-9000.
What is Randall Bennett's specialty?
The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.
Is Randall Bennett enrolled in Medicare?
Yes. Randall Bennett is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Randall Bennett's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Randall Bennett reassigns Medicare benefits to Proliance Surgeons, Inc., P.S. (Puyallup, WA). The 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 Randall Bennett's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Randall Bennett was last updated on October 20, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Randall Paul Bennett, MD · NPI 1619907953
Otolaryngology physician in Puyallup, Washington. Individual provider, active in the CMS NPPES registry since July 3, 2006.
## Identity
- **NPI:** 1619907953 (Entity type: Individual)
- **Enumerated:** July 3, 2006
- **Primary specialty:** Otolaryngology · taxonomy 207Y00000X
- **State license:** MD22922 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 104 27TH AVE SE, Puyallup, WA 98374-1145
- **Phone:** (253) 770-9000 · **Fax:** (253) 770-9712
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Proliance Surgeons, Inc., P.S. (NPI 1407223985, Puyallup, WA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 20, 2015
- **Other identifiers:** Medicaid 7078017 (WA); Medicare PIN G115000969 (WA); Medicare UPIN E40311 (WA)
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Source: [NPI Profile](https://npiprofile.com/npi/1619907953) · Data from the CMS NPPES public registry.