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MR. RANDOLPH CHARLES FISH D.P.M. NPI 1063493559


NPI Information

NPI: 1063493559
Provider Name: MR. RANDOLPH CHARLES FISH, D.P.M.
Classification: Podiatrist - 213EP1101X
Entity Type: Individual

Specialization: Primary Podiatric Medicine

PECOS Registration: Yes

Address:
915 SO. 76TH ST.
TACOMA, WA
ZIP 98408
Phone: (253) 584-9530
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MR. Randolph Charles Fish, D.P.M. is a primary podiatric medicine podiatrist in Tacoma, WA with 45 years of experience. MR. Randolph Charles Fish, D.P.M. NPI is 1063493559. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Graduation Year:1979

The provider's business location address is:

915 SO. 76TH ST.
TACOMA, WA
ZIP 98408-902
Phone: (253) 584-9530
Fax: (360) 427-2769

The NPI 1063493559 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of tissue from wounds per session (HCPCS:97597)
  • Removal of skin and tissue first 20 sq cm or less (HCPCS:11042)

The enumeration date for this NPI number is 11/10/2005 and was last updated on 4/8/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213ES0131XPodiatristFoot SurgeryPO00000297WASHINGTONNo
2213EP1101XPodiatristPrimary Podiatric Medicine91-1813864WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12041490MEDICAIDWASHINGTON
2T11570MEDICARE UPIN
34972490001MEDICARE NSCWASHINGTON
4480023273MEDICARE PINWASHINGTON
5AB01980MEDICARE UPINWASHINGTON
62041494MEDICAIDWASHINGTON
7GAB01980MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.