RANDALL LEE MORRIS-OSTROM (PSY.D., LP) – Clinical Psychologist, NPI 1174891618

RANDALL LEE MORRIS-OSTROM (PSY.D., LP) is a healthcare provider. based in Golden valley, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.D., LP. They hold a License No. LP6179 (MN). The NPI Number for RANDALL LEE MORRIS-OSTROM (PSY.D., LP) is 1174891618

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
RANDALL LEE MORRIS-OSTROM (PSY.D., LP)
NPI
1174891618
Phone
(763) 746-2419
Address
701 DECATUR AVE N STE 109
Enumeration Date
12 December 2011
Last Update Date
11 December 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6514725915
Graduation Year
2016 (10 years ago)
PAC ID
4385901347
Group Practice PAC ID
6709317787
Professional Enrollment ID
I20171129001015
Address ID
MN551286625OA992XXNXXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

Provider Addresses for RANDALL LEE MORRIS-OSTROM (PSY.D., LP)

  • 701 DECATUR AVE N STE 109

    GOLDEN VALLEY, MN 554274363

    Phone: (763) 746-2419

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2017-11-29

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
I20171129001015IClinical PsychologistMNTBD

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 55427)

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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: 6709317787View full group profile
NameSpecialtyState
Marriage And Family TherapistMN
Marriage And Family TherapistMN
Clinical PsychologistIL
Nurse PractitionerMN
Marriage And Family TherapistMN
Clinical PsychologistMN
Clinical PsychologistWI
Mental Health CounselorMN
Mental Health CounselorMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

Where can patients find RANDALL LEE MORRIS-OSTROM (PSY.D., LP)'s NPI?
You can confirm RANDALL LEE MORRIS-OSTROM (PSY.D., LP) with NPI 1174891618; it appears in the national provider directory.
Does this profile mean RANDALL LEE MORRIS-OSTROM (PSY.D., LP) is currently active?
Yes — RANDALL LEE MORRIS-OSTROM (PSY.D., LP) appears active in the national provider directory.
Does RANDALL LEE MORRIS-OSTROM (PSY.D., LP) list a primary specialty?
If you are matching referrals, note Clinical Psychologist for RANDALL LEE MORRIS-OSTROM (PSY.D., LP). Clinical services aligned with this taxonomy classification.
Does RANDALL LEE MORRIS-OSTROM (PSY.D., LP) practice in Minnesota?
You will see Golden Valley, Minnesota on file for RANDALL LEE MORRIS-OSTROM (PSY.D., LP) alongside any extra practice locations.
Is RANDALL LEE MORRIS-OSTROM (PSY.D., LP) a real provider?
This page reflects official NPPES data for NPI 1174891618. Always confirm identity and privileges with the practice and licensing boards.

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