MRS. STEPHANIE TANYA RANDALL NP
NPI 1104590025
Nurse Practitioner - Family in San Diego, CA
About Mrs. Stephanie Tanya Randall Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. STEPHANIE TANYA RANDALL NP (NPI 1104590025) is an individual family provider in San Diego, California, licensed in California (95017990) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Stephanie Tanya Randall Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Stephanie Randall reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Diego, CA 92105
- Reassigned Medicare billing, California enrollment
- 1,100 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92105 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN DIEGO, CA 92105
SAN DIEGO, CA 92105
SAN DIEGO, CA 92105
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Stephanie Randall's NPI number?
The NPI number for Stephanie Randall is 1104590025. It was assigned to this individual provider in the NPPES registry on August 4, 2021. The provider is also known as Stephanie Tanya Fischer.
Where is Stephanie Randall located?
Stephanie Randall practices at 5160 Federal Blvd, San Diego, CA 92105. The listed phone number is (619) 515-2300.
What is Stephanie Randall's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Stephanie Randall enrolled in Medicare?
Yes. Stephanie Randall is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Stephanie Randall's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stephanie Randall reassigns Medicare benefits to Family Health Centers Of San Diego Inc (San Diego, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stephanie Randall's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Stephanie Randall was last updated on June 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Stephanie Tanya Randall, NP · NPI 1104590025
Family physician in San Diego, California. Individual provider, active in the CMS NPPES registry since August 4, 2021.
## Identity
- **NPI:** 1104590025 (Entity type: Individual)
- **Enumerated:** August 4, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95017990 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 5160 FEDERAL BLVD, San Diego, CA 92105
- **Phone:** (619) 515-2300
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Family Health Centers Of San Diego Inc (NPI 1336525906, San Diego, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** June 3, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1104590025) · Data from the CMS NPPES public registry.