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Deactivated NPI 1891790374 Deactivated / Inactive NPI Male Practitioner

Dr. Randall Clark , MD

Urology • Sebring, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Randall Clark has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 20, 2005
NPI Deactivation Date February 15, 2023
Total Practice Duration ~18 Years of Practice (2005 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Randall Clark, MD was a registered Urology practicing in Sebring, FL. Throughout an active medical career spanning 18 years, Dr. Clark provided care at the practice location at 4325 SUN N LAKE BLVD STE 105 until profile deactivation on 2023-02-15.

Historical Medicare Part B clinical services included automated urinalysis test, established patient outpatient office visit, follow-up hospital inpatient care per day. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

4325 Sun N Lake Blvd Ste 105

Sebring, FL 338722171

Telephone 8633822248
Fax 8633821242
Associated Practice Facility / Clinic
🏢 Eustus S Nelson Md Pa Facility NPI 1306030549

Specialty Benchmarks & Practice Insights

Comparative analytics for Urology in Sebring, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 28.4 Yrs
State Avg: 29.7 Yrs
Regional Practice Density
8 Specialists

Practicing in Sebring, FL (1082 Statewide)

Telehealth Adoption Rate
50.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
49.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2017)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
81003 Automated urinalysis test
43 36 $24.00 $3.02
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
27 23 $157.00 $100.24
99213 Established patient office or other outpatient visit, typically 15 minutes
22 21 $125.00 $67.99
99231 Follow-up hospital inpatient care per day, typically 15 minutes
16 11 $102.00 $37.53
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes
11 11 $136.00 $68.89

Medical Specialties & State Licenses

Urology Primary Specialty

NUCC Taxonomy Code: 208800000X

State License FL ME 110463

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Samantha Denton , APRN

Nurse Practitioner - Family

NPI 1316816283

Advanced Practice Registered Nurse

NPI 1326032954

Doctor of Medicine (M.D.)

NPI 1417957507

Doctor of Medicine (M.D.)

NPI 1467450171

Doctor of Medicine (M.D.)

Dr. Alexander Troum , DO

Internal Medicine - Gastroenterology

NPI 1629425533

Doctor of Osteopathic Medicine (D.O.)

NPI 1821877366

Doctor of Medicine (M.D.), MCH

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 15, 2023

Record deactivated on February 15, 2023

NPI Profile Active July 24, 2015

NPI status registered as active in NPPES database

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Updated Practice Location July 24, 2015

Registered at 4325 SUN N LAKE BLVD STE 105, SEBRING, FL 338722171 (Tel: 8633822248)

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Updated Business Mailing Address July 24, 2015

Registered at 4325 SUN N LAKE BLVD STE 105, SEBRING, FL 338722171 (Tel: 8633822248)

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Provider Name / Credentials Updated July 24, 2015

Recorded as RANDALL CLARK, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 24, 2015

Urology (License #ME 110463 in FL)

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Initial NPI Registration & Enumeration June 20, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1891790374
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 20, 2005
Last Update: July 24, 2015
Deactivation Date: February 15, 2023

Mailing Address

4325 Sun N Lake Blvd Ste 105

Sebring, FL 338722171

Phone: 8633822248

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.