RANDY H CARROLL (PA) – Medical Physician Assistant, NPI 1336136191
Medical Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for RANDY H CARROLL (PA)
500, Winderley Place, Maitland, Orange County, Florida, 32751, United States
SUITE 115
MAITLAND, FL 327517247
Phone: (407) 875-8784
Type: Mailing
Rollins Street, Orwin Manor, Orlando, Orange County, Florida, 32803, United States
ORLANDO, FL 328031248
Phone: (407) 303-5600
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $289.
Total Amount is formed as General ($289) + Research ($0) + Ownership ($0) = $289.
Last reported payment date: 2024-06-27 • Largest payer in this snapshot: Urgo Medical North America, LLC ($177).
Total Amount
$289
General + Research + Ownership
Payments
2
Total payment records
General Amount
$289
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Urgo Medical North America, LLC | $177 |
| Alexion Pharmaceuticals, Inc. | $112 |
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: 2004-12-14
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 |
|---|---|---|---|---|
| I20041214001213 | I | Physician Assistant | FL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32751)
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