RANDALL PAUL GROVE PA
NPI 1619969250
Physician Assistant in Myrtle Beach, SC

Q: What is Randall Grove's NPI number?

The NPI number for Randall Grove is 1619969250. It was assigned to this individual provider in the NPPES registry on August 19, 2005.

Q: What is Randall Grove's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Randall Grove was last updated on October 19, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 19, 2005PECOS Enrolled

1101 JOHNSON AVE, MYRTLE BEACH, SC 29577(843) 477-0177 Get Directions Write a Review

NPPES record last updated: October 19, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Randall Paul Grove Pa NPPES

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

RANDALL PAUL GROVE PA (NPI 1619969250) is an individual physician assistant in Myrtle Beach, South Carolina, licensed in Pennsylvania (MA001516L) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619969250

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameRANDALL PAUL GROVECredential: PA

Location Address1101 JOHNSON AVEMyrtle Beach, SC 29577-1893

Mailing Address1101 Johnson AveMyrtle Beach, SC 29577-1893 · (843) 477-0177

Phone(843) 477-0177

Sole ProprietorNo

Enumeration DateAugust 19, 2005

Last NPPES UpdateOctober 19, 2017

✔ NPI 1619969250 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in PA · MA001516L

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1101 JOHNSON AVE, Myrtle Beach, SC 29577

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Randall Paul Grove Pa 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29577 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

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$67.12 typical visit price

range $16.96 – $133.52

Typical copayment $16.78 (range $4.24 – $33.38)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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