RANDALL R SOUTHARDS (PA) – Physician Assistant, NPI 1841233186
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
3,672 PHYSICIAN ASSISTANT in WI
Provider Addresses for RANDALL R SOUTHARDS (PA)
2845 GREENBRIER RD STE 320
GREEN BAY, WI 543116519
Phone: (920) 288-8320
Fax: (920) 288-8325
Type: Location
2845 Greenbrier Rd Ste 320
Green Bay, WI 543116519
Phone: (920) 288-8320
Fax: (920) 288-8325
Type: Location
1000 N OAK AVE
MARSHFIELD, WI 544495703
Phone: (715) 387-5511
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $1,189.
Total Amount is formed as General ($1,189) + Research ($0) + Ownership ($0) = $1,189.
Last reported payment date: 2024-04-16 • Largest payer in this snapshot: Zimmer Biomet Holdings, Inc. ($1,089).
Total Amount
$1,189
General + Research + Ownership
Payments
12
Total payment records
General Amount
$1,189
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Zimmer Biomet Holdings, Inc. | $1,089 |
| CSL Behring | $99 |
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: 2026-03-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20041201000739 | I | Physician Assistant | WI | TBD |
| I20250925004892 | I | Physician Assistant | FL | TBD |
| I20260311003357 | I | Physician Assistant | KS | 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 |
|---|---|---|---|---|
| 33533 | Coronary artery bypass using artery graft, 1 graft | 11 | 11 | $0 |
Insurance plans in this area (ZIP 54311)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | WI | 33533 | Heart artery bypass to repair one artery | 22 | 22 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| N E U R O L O G Y | NY | |
| Nurse Practitioner | WI | |
| Interventional Radiology, Diagnostic Radiology | WI | |
| - | WI | |
| P S Y C H I A T R Y | IL | |
| - | MI | |
| Internal Medicine | WI | |
| Nurse Practitioner | IL | |
| Cardiovascular Disease (Cardiology) | IL |
Reviews
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