Randy W Stark, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A73186 Issued in CA

Practice address

221 Mahalani St
Wailuku, HI 96793-2526

Phone

(808) 242-2343

Fax

(808) 242-2465

NPI assigned

Jul 21, 2005

Last updated

Jul 27, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

University of California, Davis School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maui Memorial Emergency Medical Associates IncGroup PAC ID 7618224981, 23 clinicians

Lanai Emergency Medical Associates IncGroup PAC ID 9739431354, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Maui Memorial Medical Center Hospital, Wailuku, HI, CCN 120002
• Lanai Community Hospital Hospital, Lanai City, HI, CCN 121305

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Lanai Emergency Medical Associates Inc

  • Emergency Medicine Physician
  • Lanai City, HI
  • NPI 1902388085
  Medicare reassignment Care Compare group NPD
• Maui Memorial Emergency Medical Associates Inc

  • Emergency Medicine Physician
  • Wailuku, HI
  • NPI 1326531773
  Medicare reassignment Care Compare group NPD
• Randy W Stark MD Inc

  • Emergency Medicine Physician
  • Wailuku, HI
  • NPI 1295970143
  Authorized official Same address or phone

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Maui Health System a Kaiser Foundation Hospitals LLC

  dba Maui Memorial Medical Center

  • General Acute Care Hospital
  • Wailuku, HI
  • NPI 1013379460
  Care Compare affiliation
• Maui Health System a Kaiser Foundation Hospitals LLC

  dba Lanai Community Hospital

  • Critical Access Hospital
  • Lanai City, HI
  • NPI 1336501634
  Care Compare affiliation

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248652800000",
    "number": "1710987664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 STATE ST",
            "address_2": "#300",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931055602",
            "telephone_number": "805-563-3011",
            "fax_number": "805-564-5087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 MAHALANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932526",
            "telephone_number": "808-242-2343",
            "fax_number": "808-242-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "RANDY",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2009-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A73186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A731860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryon Kent Sparks, LIC. AC.
• Spencer Micahel Spencer-Perieff
• Stuart Henry Spielman, M.D.
• St. Francis Medical Center - Maui Dialysis
• Joseph J Stafford III, PH.D.
• State of Hawaii Department of Health (Maui Community Mental Health Center-Wailuku)
• State of Hawaii Department of Health
• Mia C Stclair, OTD, OTR/L
• Steadfast Physical Therapy, Inc.
• Steve E Clark MD Thelma M Yamada MD LLC

• Emergency Medicine Physician in Wailuku, HI
• Providers in Wailuku, HI by specialty
• Emergency Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; 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.