RANDY A BULLOCK (APRN W PP SUB) – Nurse Practitioner, NPI 1528099231
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,655 NURSE PRACTITIONER in UT
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Provider Addresses for RANDY A BULLOCK (APRN W PP SUB)
237, 26th Street, 25th Street, Ogden, Weber County, Utah, 84401, United States
OGDEN, UT 844013105
Phone: (801) 625-3605
Fax: (801) 625-3615
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 11 Open Payments records for all available years, with a total value of $207.
Total Amount is formed as General ($207) + Research ($0) + Ownership ($0) = $207.
Last reported payment date: 2024-12-02 • Largest payer in this snapshot: Indivior Inc. ($73).
Total Amount
$207
General + Research + Ownership
Payments
11
Total payment records
General Amount
$207
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-02
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2004-02-06
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 |
|---|---|---|---|---|
| I20040206000796 | I | Nurse Practitioner | UT | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 235 | 72 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 155 | 22 | $0 |
Insurance plans in this area (ZIP 84401)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | UT | 90792 | Psychiatric diagnostic evaluation with medical services | 15 | 13 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | UT | |
| Nurse Practitioner | UT | |
| - | UT | |
| - | UT | |
| Clinical Social Worker | UT | |
| - | UT | |
| Clinical Social Worker | UT | |
| - | UT | |
| Family Practice | UT | |
| - | UT |
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