RANDALL ALAN ROARK (N.P.) – Family Nurse Practitioner, NPI 1447312178
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,360 NURSE PRACTITIONER in CA
Provider Addresses for RANDALL ALAN ROARK (N.P.)
Imperial Beach, San Diego County, California, 91932, United States
IMPERIAL BEACH, CA 919330459
Phone: (619) 429-3733
Fax: (619) 628-5550
Type: Mailing
1695 N SUNRISE WAY
PALM SPRINGS, CA 922623701
Phone: (760) 323-2118
Type: Location
72724 29 Palms Hwy Ste 103
29 Palms, CA 922772459
Phone: (760) 367-5906
Fax: (760) 367-5986
Type: Location
949, Palm Avenue, Imperial Beach, San Diego County, California, 91932, United States
IMPERIAL BEACH, CA 91932
Phone: (619) 429-3733
Fax: (619) 628-5550
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $49.
Total Amount is formed as General ($49) + Research ($0) + Ownership ($0) = $49.
Last reported payment date: 2024-09-20 • Largest payer in this snapshot: Antares Pharma, Inc. ($33).
Total Amount
$49
General + Research + Ownership
Payments
2
Total payment records
General Amount
$49
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Antares Pharma, Inc. | $33 |
| ViiV Healthcare Company | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-01-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070402000252 | I | Nurse Practitioner | CA | TBD |
| I20160128002527 | I | Nurse Practitioner | OR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 91933)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | AZ | |
| Internal Medicine, Infectious Disease | CA | |
| - | CA | |
| Family Practice | CA | |
| Emergency Medicine | CA | |
| P S Y C H I A T R Y | CA | |
| Physician Assistant | CA | |
| Nurse Practitioner | CA | |
| Physician Assistant | CA | |
| Internal Medicine | CA |
Reviews
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