RANDALL K ROENIGK (M.D.) – MOHS-Micrographic Surgery Physician, NPI 1336126424
MOHS-Micrographic Surgery Physician
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NPPES metrics only — not quality of care.
145 MICROGRAPHIC DERMATOLOGIC SURGERY (MDS) in FL
Provider Addresses for RANDALL K ROENIGK (M.D.)
4500 San Pablo Rd S
Jacksonville, FL 322241865
Phone: (904) 953-2000
Type: Location
13400 E Shea Blvd
Scottsdale, AZ 852595452
Phone: (480) 301-8000
Type: Location
1st Street Southwest, Rochester, Olmsted County, Minnesota, 55903, United States
ROCHESTER, MN 559050001
Phone: (507) 284-2511
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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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: 2010-01-18
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 |
|---|---|---|---|---|
| I20100118000304 | I | Micrographic Dermatologic Surgery (Mds) | MN | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17311 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | 144 | 112 | $0 |
| 17312 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks | 36 | 24 | $0 |
| 12052 | Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm | 28 | 28 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 27 | 11 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 23 | 23 | $0 |
Insurance plans in this area (ZIP 32224)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | MN | 11101 | Biopsy of each additional growth of skin and/or tissue | 64 | 36 |
| DERMATOLOGY | MN | 13132 | Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 109 | 108 |
| DERMATOLOGY | MN | 17003 | Destruction of 2-14 skin growths | 59 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WA | |
| Psychiatry, Addiction Medicine | MN | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN | |
| O P H T H A L M O L O G Y | MN | |
| - | MN | |
| - | MN | |
| - | MN |
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