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
  • Specialization: Primary Podiatric Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 915 SO. 76TH ST.
    TACOMA, WA
    ZIP 98408
  • Phone: (253) 584-9530

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NPI Details

MR. Randolph Charles Fish, D.P.M. is a primary podiatric medicine podiatrist in Tacoma, WA with 47 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.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Removal of tissue from wound, 20.0 sq cm or less (HCPCS:97597)
  • Removal of skin and tissue, 20.0 sq cm or less (HCPCS:11042)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Application of chemical to stop tissue regrowth in wound (HCPCS:17250)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other 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: 11/21/2025

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