RILEY RANDOL LEE JR (APRN) – Nurse Practitioner, NPI 1265139976

RILEY RANDOL LEE JR (APRN) is a healthcare provider. based in Leesburg, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. APRN11024113 (FL). The NPI Number for RILEY RANDOL LEE JR (APRN) is 1265139976

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
RILEY RANDOL LEE JR (APRN)
NPI
1265139976
Phone
(352) 315-1627
Address
1038 W. NORTH BLVD
Enumeration Date
13 February 2023
Last Update Date
13 February 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3527325552
Graduation Year
2022 (4 years ago)
PAC ID
5991161440
Group Practice PAC ID
4587651492
Professional Enrollment ID
I20230525001966
Address ID
FL344718101OC1834XAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

24,243 NURSE PRACTITIONER in FL

Provider Addresses for RILEY RANDOL LEE JR (APRN)

  • 1038 W. NORTH BLVD

    SUITE 102

    LEESBURG, FL 347485077

    Phone: (352) 315-1627

    Fax: (352) 326-8744

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 258 Open Payments records for all available years, with a total value of $11,638.

Total Amount is formed as General ($10,034) + Research ($1,604) + Ownership ($0) = $11,638.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Pulmonx Corporation ($3,498).

Total Amount

$11,638

General + Research + Ownership

Payments

258

Total payment records

General Amount

$10,034

General payments

Research Amount

$1,604

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2023-05-25

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230525001966INurse PractitionerFLTBD

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.

Verify on CMS Revalidation Lookup Tool

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 34748)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587651492View full group profile
NameSpecialtyState
Nurse PractitionerFL
Pulmonary Disease, Critical Care (Intensivists)FL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Pulmonary DiseaseFL
Pulmonary Disease, Critical Care (Intensivists)FL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What is the 10-digit NPI for RILEY RANDOL LEE JR (APRN)?
RILEY RANDOL LEE JR (APRN) — NPI 1265139976 — is the standard way to identify this listing.
Is RILEY RANDOL LEE JR (APRN) still practicing?
RILEY RANDOL LEE JR (APRN) is currently listed as active in the public NPI registry.
What is RILEY RANDOL LEE JR (APRN) best known for clinically?
Directory data describes RILEY RANDOL LEE JR (APRN) with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is RILEY RANDOL LEE JR (APRN) based?
RILEY RANDOL LEE JR (APRN) is tied to Leesburg, Florida in the data we show; additional addresses may exist on the full record.
Is the information about RILEY RANDOL LEE JR (APRN) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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