MR. RANDALL DOUGLAS KELLY MHS, DMSC, PA-C
NPI 1922393974
Physician Assistant in Hermiston, OR
About Mr. Randall Douglas Kelly Mhs, Dmsc, Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. RANDALL DOUGLAS KELLY MHS, DMSC, PA-C (NPI 1922393974) is an individual physician assistant in Hermiston, Oregon, licensed in Oregon (PA184529) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS and is a graduate of Other (2010).
NPPES Registry Identity
Specialties & Licenses 4
Other Identifiers 2
Accepted 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
Mr. Randall Douglas Kelly Mhs, Dmsc, Pa-c 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97838 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 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
HERMISTON, OR 97838
HERMISTON, OR 97838
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 Kelly's NPI number?
The NPI number for Randall Kelly is 1922393974. It was assigned to this individual provider in the NPPES registry on June 16, 2011.
Where is Randall Kelly located?
Randall Kelly practices at 256 E Hurlburt Ave Ste 117, Hermiston, OR 97838. The listed phone number is (541) 303-3558.
What is Randall Kelly's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Randall Kelly enrolled in Medicare?
Yes. Randall Kelly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
What insurance does Randall Kelly accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan and 1 other insurer list Randall Kelly as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Randall Kelly was last updated on March 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Mr. Randall Douglas Kelly, MHS, DMSC, PA-C · NPI 1922393974
Physician Assistant physician in Hermiston, Oregon. Individual provider, active in the CMS NPPES registry since June 16, 2011.
## Identity
- **NPI:** 1922393974 (Entity type: Individual)
- **Enumerated:** June 16, 2011
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **State license:** PA184529 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 256 E HURLBURT AVE STE 117, Hermiston, OR 97838-2443
- **Phone:** (541) 303-3558 · **Fax:** (509) 593-4644
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2010
## Record status
- **NPPES last updated:** March 27, 2026
- **Other identifiers:** Medicaid 2013576 (WA); Other 0281857 (WA)
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Source: [NPI Profile](https://npiprofile.com/npi/1922393974) · Data from the CMS NPPES public registry.