MR. RANDY WAYNE JR. LASUT (CRNP FNP-C) – Family Nurse Practitioner, NPI 1063282994

MR. RANDY WAYNE JR. LASUT (CRNP FNP-C) is a healthcare provider. based in New paris, Pennsylvania. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP FNP-C. They hold a License No. SP029010 (PA). The NPI Number for MR. RANDY WAYNE JR. LASUT (CRNP FNP-C) is 1063282994

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
MR. RANDY WAYNE JR. LASUT (CRNP FNP-C)
NPI
1063282994
Phone
(814) 839-4108
Address
4186 CORTLAND DR
Enumeration Date
2 January 2024
Last Update Date
30 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2023 (3 years ago)
PAC ID
8820433089
Group Practice PAC ID
7810281946
Professional Enrollment ID
I20240318003711
Address ID
PA155547706NE4186XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

11,473 NURSE PRACTITIONER in PA

Provider Addresses for MR. RANDY WAYNE JR. LASUT (CRNP FNP-C)

  • 4186 CORTLAND DR

    NEW PARIS, PA 155547706

    Phone: (814) 839-4108

    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 53 Open Payments records for all available years, with a total value of $884.

Total Amount is formed as General ($884) + Research ($0) + Ownership ($0) = $884.

Last reported payment date: 2024-12-31 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($77).

Total Amount

$884

General + Research + Ownership

Payments

53

Total payment records

General Amount

$884

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-31

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: 2024-03-18

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240318003711INurse PractitionerPATBD

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 15554)

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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: 7810281946View full group profile
NameSpecialtyState
-PA
Nurse PractitionerPA
Nurse PractitionerPA
Nurse PractitionerPA
Physician AssistantPA
Family PracticePA
Physician AssistantPA
Family PracticePA
Nurse PractitionerPA
Physician AssistantPA

Reviews

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Frequently asked questions

Does MR. RANDY WAYNE JR. LASUT (CRNP FNP-C) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MR. RANDY WAYNE JR. LASUT (CRNP FNP-C) uses 1063282994.
Does the file indicate MR. RANDY WAYNE JR. LASUT (CRNP FNP-C) is practicing under active NPI?
Directory data currently reports MR. RANDY WAYNE JR. LASUT (CRNP FNP-C) as active.
What is MR. RANDY WAYNE JR. LASUT (CRNP FNP-C)'s specialty?
The listing groups MR. RANDY WAYNE JR. LASUT (CRNP FNP-C) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What area does MR. RANDY WAYNE JR. LASUT (CRNP FNP-C) serve?
MR. RANDY WAYNE JR. LASUT (CRNP FNP-C)'s listing highlights New Paris, Pennsylvania; more addresses can appear in NPPES.
Is the information about MR. RANDY WAYNE JR. LASUT (CRNP FNP-C) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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