JOE RANDALL MONROE (PA) – Physician Assistant, NPI 1083613822

JOE RANDALL MONROE (PA) is a healthcare provider. based in Oklahoma city, Oklahoma. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. PA1052 (OK). The NPI Number for JOE RANDALL MONROE (PA) is 1083613822

Main info

Male
48 Years Of Experience
Accepts Medicare Assignment
Name
JOE RANDALL MONROE (PA)
NPI
1083613822
Phone
(405) 636-1506
Address
4805 S WESTERN AVE
Enumeration Date
14 July 2005
Last Update Date
22 October 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9187600700
Graduation Year
1978 (48 years ago)
PAC ID
4486621505
Group Practice PAC ID
9234487554
Professional Enrollment ID
I20040916000640
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for JOE RANDALL MONROE (PA)

  • South Western Avenue, Oklahoma City, Oklahoma County, Oklahoma, 73139, United States

    OKLAHOMA CITY, OK 731093835

    Phone: (405) 636-1506

    Fax: (405) 636-1511

    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 6 Open Payments records for all available years, with a total value of $453.

Total Amount is formed as General ($453) + Research ($0) + Ownership ($0) = $453.

Last reported payment date: 2024-09-05 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($174).

Total Amount

$453

General + Research + Ownership

Payments

6

Total payment records

General Amount

$453

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-05

Latest reported date

Top Companies

Largest payers in this snapshot

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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: 2004-09-16

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
I20040916000640IPhysician AssistantOKTBD

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 73109)

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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: 9234487554View full group profile
NameSpecialtyState
Micrographic Dermatologic Surgery (Mds)OK
Physician AssistantOK
Physician AssistantOK
D E R M A T O L O G YOK
Physician AssistantOK
Physician AssistantOK
Physician AssistantHI
D E R M A T O L O G YOK
Physician AssistantOK
Physician AssistantOK

Reviews

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Frequently asked questions

Does JOE RANDALL MONROE (PA) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — JOE RANDALL MONROE (PA) uses 1083613822.
Does the file indicate JOE RANDALL MONROE (PA) is practicing under active NPI?
Directory data currently reports JOE RANDALL MONROE (PA) as active.
What taxonomy line describes JOE RANDALL MONROE (PA)?
For research purposes, treat JOE RANDALL MONROE (PA) as Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect JOE RANDALL MONROE (PA) on a map?
Expect Oklahoma City, Oklahoma as a primary anchor for JOE RANDALL MONROE (PA) unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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