RANDOLPH BOURNE MD
NPI 1881735736
Obstetrics & Gynecology in Edmonds, WA

Q: What is Randolph Bourne's NPI number?

The NPI number for Randolph Bourne is 1881735736. It was assigned to this individual provider in the NPPES registry on February 12, 2007.

Q: What is Randolph Bourne's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Randolph Bourne was last updated on October 10, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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 February 12, 2007PECOS EnrolledAccepts Medicare Assignment

21616 76TH AVE W STE 205, EDMONDS, WA 98026(425) 640-4810(425) 640-4884 Get Directions Write a Review

NPPES record last updated: October 10, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Randolph Bourne Md NPPES

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

RANDOLPH BOURNE MD (NPI 1881735736) is an individual obstetrics & gynecology provider in Edmonds, Washington, licensed in Washington (MD00047603) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS, is affiliated with Swedish Edmonds Hospital, and is a graduate of Vanderbilt University School Of Medicine (2003).

NPPES Registry Identity

NPI1881735736

Entity TypeIndividualMale

Primary Taxonomy207V00000X

Provider Legal NameRANDOLPH BOURNECredential: MD

Location Address21616 76TH AVE W STE 205Edmonds, WA 98026-7512

Mailing Address21616 76th Ave W Ste 205Edmonds, WA 98026-7512 · (425) 640-4810 · Fax (425) 640-4998

Phone(425) 640-4810

Fax(425) 640-4884

Sole ProprietorNo

Medical School CMSVanderbilt University School Of MedicineGraduated 2003

Enumeration DateFebruary 12, 2007

Last NPPES UpdateOctober 10, 2007

✔ NPI 1881735736 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in WA · MD00047603

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

21616 76TH AVE W STE 205, Edmonds, WA 98026

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Other Identifiers 2

Medicaid8483646WA

Medicare PING8866498WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.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

Randolph Bourne 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 ID6800987058

PECOS Enrollment IDI20070802000432

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.

Hospital Affiliations CMS Care Compare

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

Swedish Edmonds Hospital

Acute Care Hospitals · Edmonds, WA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500026

Location21601 76th Avenue WestEdmonds, WA 98026 · Snohomish County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98026 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

$130.99 typical visit price

range $57.27 – $172.80

Typical copayment $32.74 (range $14.31 – $43.20)

Most-billed visit code 99204

Established Patient

$71.29 typical visit price

range $18.56 – $141.11

Typical copayment $17.82 (range $4.64 – $35.27)

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.

Other Providers at the Same Location NPPES 14

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

CAROLYN KAY MD

Obstetrics & Gynecology