NPIMap

Individual provider Active NPI

Randall David Marosok, M.D.

  • Infectious Disease Physician
  • Gastonia, NC
National Provider Identifier
1780671479
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
38130 Issued in NC
Practice address
660 Summit Crossing PL
Suite 306
Gastonia, NC 28054-2104
Phone
(704) 671-7830
Fax
(704) 671-7835
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 28683 SC
Infectious Disease Physician 207RI0200X 38130 NC Primary

Addresses

Primary practice location

660 Summit Crossing PL
Suite 306
Gastonia, NC 28054-2104

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 834-2450

Other practice location 1

2555 Court Dr Ste 350
Gastonia, NC 28054-2186
Phone (704) 834-2465

Other identifiers 1

IdentifierTypeStateIssuer
GP1016MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150921001564 NC Practitioner - Internal MedicinePractitioner - Infectious Disease 4082505276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Creighton University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

2555 Court Dr
Suite 450
Gastonia, NC 28054-2191
Phone (704) 671-7652

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue444
Removal of skin lesions19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38130NCMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group, Inc. CurrentSince Jul 15, 2015 Accepting new patients
Caromont Medical Group Inc CurrentSince Jul 15, 2015 Accepting new patients
Caromont Medical Group Inc Infectious Disease Current Accepting new patients
Gaston Memorial Hospital, Incorporated Past Accepting new patients

Locations

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

660 Summit Crossing Pl
Ste 306
Gastonia, NC 28054
Phone (704) 671-7830

2555 Court Dr
Ste 350
Gastonia, NC 28054
Phone (704) 671-6912

2544 Court Dr
Ste A
Gastonia, NC 28054
Phone (704) 671-6400

2555 Court Dr
Ste 450
Gastonia, NC 28054
Phone (704) 671-7652

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

Organizations & group practices 4

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1780671479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "704-834-2450",
            "fax_number": "704-671-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 SUMMIT CROSSING PL",
            "address_2": "SUITE 306",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542104",
            "telephone_number": "704-671-7830",
            "fax_number": "704-671-7835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2555 Court Dr Ste 350",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280542186",
            "country_code": "US",
            "telephone_number": "704-834-2465",
            "fax_number": "704-834-2466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAROSOK",
        "first_name": "RANDALL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "SC",
            "license": "28683",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NC",
            "license": "38130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1016",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.