MS. RANDI LEE HOLMES (PA) – Physician Assistant, NPI 1720421779
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,564 PHYSICIAN ASSISTANT in CA
Provider Addresses for MS. RANDI LEE HOLMES (PA)
PO BOX 27128
SALT LAKE CITY, UT 841270128
Phone:
Type: Mailing
4232 CEDAR AVE
NORCO, CA 928601216
Phone: (951) 205-1052
Type: Mailing
98 N 1100 E STE 101
AMERICAN FORK, UT 840032940
Phone: (801) 492-2550
Type: Location
4232 Cedar Ave
Norco, CA 928601216
Phone: (951) 205-1052
Type: Location
5171 S Cottonwood St Ste 740
Murray, UT 841075705
Phone: (801) 507-9700
Type: Location
5762 W 8055 S APT M106
WEST JORDAN, UT 840813137
Phone: (951) 205-1052
Type: Mailing
5171 S COTTONWOOD ST STE 740
MURRAY, UT 841075705
Phone: (801) 507-9700
Type: Location
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: 2021-02-24
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 |
|---|---|---|---|---|
| I20210224000710 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 22 | 21 | $0 |
Insurance plans in this area (ZIP 84127)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OR | |
| Diagnostic Radiology | UT | |
| Family Practice | UT | |
| H O S P I T A L I S T | UT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | UT | |
| - | UT | |
| - | UT | |
| - | UT | |
| Family Practice | UT | |
| - | UT |
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