DR. RANDALL ELLIS JACK M.D.
NPI 1922044437
Obstetrics & Gynecology - Gynecology in Reno, NV
NPI Status: Active since June 22, 2006
Contact Information
635 INNOVATION DR STE 300
RENO, NV
ZIP 89511
Phone: (775) 329-6241
Fax: (775) 329-4921
- Individual
- Male
- Obstetrics & Gynecology
- Gynecology
- PECOS Enrolled
- Opted-Out Medicare
About RANDALL JACK
This page provides the complete NPI Profile along with additional information for Randall Jack, a women's health care provider established in Reno, Nevada with a medical specialization in Obstetrics & Gynecology, focusing in gynecology . The healthcare provider is registered in the NPI registry with number 1922044437 assigned on June 2006. The practitioner's primary taxonomy code is 207VG0400X with license number 13040 (NV). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1922044437
- Provider Name
- DR. RANDALL ELLIS JACK M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 635 INNOVATION DR STE 300 RENO, NV 89511
- Location Phone
- (775) 329-6241
- Location Fax
- (775) 329-4921
- Mailing Address
- 635 INNOVATION DR STE 300 RENO, NV 89511
- Mailing Phone
- (775) 329-6241
- Mailing Fax
- (775) 329-4921
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-22-2006
- Last Update Date
- 04-12-2024
- Code Navigator
Women's health care providers like Randall Jack treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Randall Jack opted out of Medicare effective on 04-01-2015 until 04-01-2025. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Obstetrics & Gynecology Gynecology
- Taxonomy Code
- 207VG0400X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 13040
- License State
- NV
- Taxonomy Description
- A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee
Medicare Participation & PECOS Enrollment Status
Randall Jack is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-01-2015
Opt-Out End Date: 04-01-2025
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 89511 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $131.25
- Minimum New Patient Price $57.07
- Maximum New Patient Price $173.24
- Average New Patient Copayment $32.81
- Minimum New Patient Copayment $14.26
- Maximum New Patient Copayment $43.31
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $71.14
- Minimum Established Patient Price $18.27
- Maximum Established Patient Price $140.96
- Average Established Patient Copayment $17.78
- Minimum Established Patient Copayment $4.56
- Maximum Established Patient Copayment $35.24
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Reviews for DR. RANDALL ELLIS JACK M.D.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 9 | 2 | 2 | 0 | 4 | 4 | 4 | 3 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 4 | 2 | 0 | 4 | 8 | 4 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 4 + 2 + 0 + 4 + 8 + 4 + 6 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1922044437 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 19 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1023714144 | MACKENZIE ROSETTE APRN Individual | Nurse Practitioner (Women's Health) | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1043417868 | SARA MELANIE WORKING M.D. Individual | Obstetrics & Gynecology | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1174528277 | STACI M PAUL M.D. Individual | Obstetrics & Gynecology (Gynecology) | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1215963400 | PETER BENJAMIN DEKAY MD Individual | Obstetrics & Gynecology | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1285207605 | ALLYSON STADE PIMPL APRN, FNP, AGACNP Individual | Nurse Practitioner (Women's Health) | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1366520280 | STACY ELDON MELLUM M.D. Individual | Obstetrics & Gynecology | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1437154531 | SHERRIE ANNE HALD MD Individual | Obstetrics & Gynecology (Gynecology) | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1619291598 | MR. NICHOLAS JAMES GAROL M.S. Individual | Obstetrics & Gynecology | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1629229265 | DR. CYNTHIA LYNN ST. PIERRE M.D. Individual | Obstetrics & Gynecology | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1629465463 | HILARY ALLEN Individual | Obstetrics & Gynecology | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1811992910 | DR. CORINNE ELIZABETH CAPURRO MD Individual | Obstetrics & Gynecology | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1861836025 | IOLANDA EDSALL M.D. Individual | Obstetrics & Gynecology | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1881709574 | DR. VICKIE LEE TIPPETT MD Individual | Obstetrics & Gynecology | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1902113210 | MRS. ANN CECELIA MORTARA APN Individual | Nurse Practitioner (Women's Health) | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1962454090 | DR. LAURA BLACH THOMPSON MD Individual | Obstetrics & Gynecology | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1992888283 | OB-GYN ASSOCIATES LTD Organization | Obstetrics & Gynecology | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1992896070 | SUSAN DIGRAZIA PERRY M.D. Individual | Obstetrics & Gynecology | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1225382161 | JENNIFER ZIOCK-PRICE MD Individual | Obstetrics & Gynecology | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
| 1386892545 | ANN MARIE RICKS MD Individual | Obstetrics & Gynecology | 635 INNOVATION DR STE 300 RENO, NV 89511 (775) 329-6241 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1922044437, enumerated in the NPI registry as an "individual" on June 22, 2006
The provider is located at 635 Innovation Dr Ste 300 Reno, Nv 89511 and the phone number is (775) 329-6241
The provider's speciality is Obstetrics & Gynecology with taxonomy code 207VG0400X with a focus in Gynecology
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $131.25 with an average copayment of $32.81 for new patient appointments. Established patients should expect a typical charge of $71.14 and an average copayment of 17.78. Please review your insurance plan or contact the provider directly to determine your specific costs.
No, the provider signed an affidavit on April 01, 2015 to opt-out of the Medicare program. The provider is excluded from the Medicare program until April 01, 2025.
This NPI record was last updated on June 22, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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