RANDALL J. BOLAR M.D. NPI 1558323246

NPI Information

  • NPI: 1558323246
  • Provider Name: RANDALL J. BOLAR, M.D.
  • Classification: Surgery - 208600000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1027 WASHINGTON AVE
    DETROIT LAKES, MN
    ZIP 56501
  • Phone: (218) 847-5611

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NPI Details

Randall J. Bolar, M.D. is a surgery in Detroit Lakes, MN. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. Randall J. Bolar, M.D. NPI is 1558323246. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1027 WASHINGTON AVE
DETROIT LAKES, MN
ZIP 56501-409
Phone: (218) 847-5611
Fax: (218) 847-0881

The NPI 1558323246 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), Power Mobility Devices.

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)
  • Colorectal cancer screening; colonoscopy on individual at high risk (HCPCS:G0105)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Diagnostic exam of large bowel using a flexible endoscope (HCPCS:45378)
  • Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery (HCPCS:45384)
  • Removal of polyps or growths of large bowel using an endoscope with mechanical snare (HCPCS:45385)
  • Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43235)
  • Colonoscopy (HCPCS:NAN13)
  • Hernia repair - groin (open) (HCPCS:NAN19)
  • Upper gastrointestinal (GI) endoscopy for acid reflux (HCPCS:NAN12)

The enumeration date for this NPI number is 4/6/2006 and was last updated on 12/23/2015.

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
1208600000XSurgery34949TENNESSEENo
2208600000XSurgery36945MINNESOTAYes

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
110802394OTHERCAQH
2000000069481OTHERKENTUCKYANTHEM BC
364357130MEDICAIDKENTUCKY
41515147MEDICAIDTENNESSEE
5H400122469MEDICARE PINMINNESOTA
64221186OTHERTENNESSEEBCBS
701281517OTHERTENNESSEEAMERIGROUP
83338849MEDICAIDTENNESSEE
933388491MEDICARE PINTENNESSEE
107774037OTHERKENTUCKYAETNA
11203500913011OTHERTENNESSEETRICARE
12TN0125OTHERTENNESSEEAMERICHOICE
131558323246MEDICAIDMINNESOTA

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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