KIMBERLEE RANDALL (PA-C) – Physician Assistant, NPI 1194126565
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
9,232 PHYSICIAN ASSISTANT in FL
Provider Addresses for KIMBERLEE RANDALL (PA-C)
2402 FRIST BLVD
#102
FORT PIERCE, FL 349504838
Phone: (772) 456-4561
Type: Location
2402 FRIST BLVD STE 103
FORT PIERCE, FL 349504838
Phone: (772) 465-4651
Fax: (772) 465-8689
Type: Mailing
2402 Frist Blvd
#102
Fort Pierce, FL 349504838
Phone: (772) 456-4561
Type: Location
403 1st St SE
Belmond, IA 504211201
Phone: (641) 444-3500
Fax: (319) 343-1161
Type: Location
1316 S MAIN ST
CLARION, IA 505252019
Phone: (515) 532-2811
Fax: (515) 532-3119
Type: Mailing
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: 2024-08-13 • Largest payer in this snapshot: Pacira Pharmaceuticals Incorporated ($25).
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
2024-08-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Pacira Pharmaceuticals Incorporated | $25 |
| KCI USA, Inc. | $24 |
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: 2014-12-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20141211000423 | I | Physician Assistant | FL | 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 34950)
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