Randall J Bolar, MD - Medicare General Surgery in Detroit Lakes, MN

Randall J Bolar, MD is a medicare enrolled "Surgery" physician in Detroit Lakes, Minnesota. He went to Wright State University Boonshoft School Of Medicine and graduated in 1983 and has 41 years of diverse experience with area of expertise as General Surgery. He is a member of the group practice St Marys Regional Health Center and his current practice location is 1027 Washington Ave, Detroit Lakes, Minnesota. You can reach out to his office (for appointments etc.) via phone at (218) 847-5611.

Randall J Bolar is licensed to practice in Minnesota (license number 36945) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1558323246.

Contact Information

Randall J Bolar, MD
1027 Washington Ave,
Detroit Lakes, MN 56501-3409
(218) 847-5611
(218) 847-0881



Physician's Profile

Full NameRandall J Bolar
GenderMale
SpecialityGeneral Surgery
Experience41 Years
Location1027 Washington Ave, Detroit Lakes, Minnesota
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Randall J Bolar attended and graduated from Wright State University Boonshoft School Of Medicine in 1983
  NPI Data:
  • NPI Number: 1558323246
  • Provider Enumeration Date: 04/06/2006
  • Last Update Date: 12/23/2015
  Medicare PECOS Information:
  • PECOS PAC ID: 3274560396
  • Enrollment ID: I20120423000743

Medical Identifiers

Medical identifiers for Randall J Bolar such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1558323246NPI-NPPES
1515147MedicaidTN
TN0125OtherTNAMERICHOICE
203500913011OtherTNTRICARE
000000069481OtherKYANTHEM BC
10802394OtherCAQH
1558323246MedicaidMN
01281517OtherTNAMERIGROUP
4221186OtherTNBCBS
64357130MedicaidKY
7774037OtherKYAETNA
3338849MedicaidTN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208600000XSurgery 34949 (Tennessee)Secondary
208600000XSurgery 36945 (Minnesota)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Essentia Health St Marys - Detroit LakesDetroit lakes, MNHospital
Essentia Health FosstonFosston, MNHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
St Marys Regional Health Center2062326820159

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Randall J Bolar allows following entities to bill medicare on his behalf.
Entity NameSt Marys Regional Health Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1679561088
PECOS PAC ID: 2062326820
Enrollment ID: O20031117000090

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Entity NameFirst Care Medical Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073638565
PECOS PAC ID: 3678542842
Enrollment ID: O20040927000035

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Entity NameInnovis Health Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659617504
PECOS PAC ID: 9931298155
Enrollment ID: O20080115000831

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Randall J Bolar is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Randall J Bolar, MD
1027 Washington Ave,
Detroit Lakes, MN 56501-3409

Ph: (218) 847-5611
Randall J Bolar, MD
1027 Washington Ave,
Detroit Lakes, MN 56501-3409

Ph: (218) 847-5611

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Surgery Doctors in Detroit Lakes, MN

George A Portilla, MD
Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501
Phone: 218-847-5611    Fax: 218-847-0881
Travis David Swartz, D.O.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 1027 Washington Avenue, Eh St Mary's Detroit Lakes Clinic, Detroit Lakes, MN 56501
Phone: 218-847-5611    
Mitchell B Goldstein, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 1245 Washington Ave, Detroit Lakes, MN 56501
Phone: 218-846-2000    Fax: 218-846-2114
Shang-yee S Yeh, MD
Surgery
Medicare: Medicare Enrolled
Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501
Phone: 218-844-2347    

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