Randall Alan Roark, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

15996 Issued in CA

Practice address

1695 N Sunrise Way
Palm Springs, CA 92262-3701

Phone

(760) 323-2118

NPI assigned

Dec 16, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

University of California, San Francisco School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dap Health IncGroup PAC ID 6002989522, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rroark651998@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dap Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Palm Springs, CA
  • NPI 1306464326
  Medicare reassignment Care Compare group NPD
• Multnomah County

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1609914787
  Medicare reassignment NPD
• Dap Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Anza, CA
  • NPI 1942623657
  NPD
• Multnomah County

  • Case Management Agency
  • Portland, OR
  • NPI 1538391073
  NPD
• Multnomah County

  • Federally Qualified Health Center (FQHC)
  • Gresham, OR
  • NPI 1912322074
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1447312178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 N SUNRISE WAY",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922623701",
            "telephone_number": "760-323-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 N SUNRISE WAY",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922623701",
            "telephone_number": "760-323-2118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "72724 29 Palms Hwy Ste 103",
            "address_purpose": "LOCATION",
            "city": "29 Palms",
            "state": "CA",
            "postal_code": "922772459",
            "country_code": "US",
            "telephone_number": "760-367-5906",
            "fax_number": "760-367-5986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROARK",
        "first_name": "RANDALL",
        "middle_name": "ALAN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-16",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "568148",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "15996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcela Rivera
• Norma Rivera
• Riverside Orthopedic Contract Services AMC
• Riverside Recovery Resources
• John Michel Rivett
• Robert S Robbins, MD
• Marc Daniel Roberge, LMT
• Robert F. Bernstein, M.D., a Medical Corporation
• Robert J Rosser, MD, a Professional Corporation
• Robert Neal Rouzier, M.D., Inc

• Family Nurse Practitioner in Palm Springs, CA
• Providers in Palm Springs, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.