DR. RANDY GILLILAND PH.D.
NPI 1629431788
Psychologist - Clinical in Provo, UT

Q: What is Randy Gilliland's NPI number?

The NPI number for Randy Gilliland is 1629431788. It was assigned to this individual provider in the NPPES registry on April 5, 2016.

Q: What is Randy Gilliland's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Randy Gilliland was last updated on October 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since April 05, 2016PECOS EnrolledAccepts Medicare Assignment

395 W COUGAR BLVD STE 803, PROVO, UT 84604(801) 235-7246 Get Directions Write a Review

NPPES record last updated: October 25, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Dr. Randy Gilliland Ph.d. NPPES

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

DR. RANDY GILLILAND PH.D. (NPI 1629431788) is an individual clinical provider in Provo, Utah, licensed in Utah (9655966-2501) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1629431788

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. RANDY GILLILANDCredential: PH.D.

Location Address395 W COUGAR BLVD STE 803Provo, UT 84604-3311

Mailing AddressPo Box 27128Salt Lake City, UT 84127-0128

Phone(801) 235-7246

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateApril 5, 2016

Last NPPES UpdateOctober 25, 2024

NPPES CertifiedOctober 25, 2024

✔ NPI 1629431788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in UT · 9655966-2501

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

395 W COUGAR BLVD STE 803, Provo, UT 84604

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.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

Dr. Randy Gilliland Ph.d. 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 ID7719251446

PECOS Enrollment IDI20171003007252

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 Randy Gilliland reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ihc Health Services Inc

Same address

Family

395 W COUGAR BLVD STE 802
Provo, UT 84604

Reassigned Medicare billing, Utah enrollment
3,691 clinicians in this Medicare group

NPI 1083411797 (801) 357-0260

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

Areas of Expertise CMS Part B claims

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.

Psychiatric diagnostic evaluation 90791

A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.

17 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84604 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

$166.03 typical visit price

range $54.34 – $166.03

Typical copayment $41.50 (range $13.58 – $41.50)

Most-billed visit code 99205

Established Patient

$96.35 typical visit price

range $17.23 – $135.20

Typical copayment $24.08 (range $4.30 – $33.80)

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 10

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

ERIC GHELFI PHD

Psychologist (Clinical)