SAMANTHA ROSE ELLIS (M.D.) – Dermatology Physician, NPI 1174918098
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,140 DERMATOLOGY in CA
Provider Addresses for SAMANTHA ROSE ELLIS (M.D.)
3301 C St
Suite 1400
Sacramento, CA 958163300
Phone: (916) 734-6371
Type: Location
3301 C ST
SUITE 1400
SACRAMENTO, CA 958163300
Phone:
Type: Mailing
600 SAN RAMON VALLEY BLVD STE 102
DANVILLE, CA 945264021
Phone: (925) 838-4900
Fax: (925) 838-4920
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 31 Open Payments records for all available years, with a total value of $168,591.
Total Amount is formed as General ($168,591) + Research ($0) + Ownership ($0) = $168,591.
Last reported payment date: 2024-11-21 • Largest payer in this snapshot: Galderma Laboratories, L.P. ($168,162).
Total Amount
$168,591
General + Research + Ownership
Payments
31
Total payment records
General Amount
$168,591
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Galderma Laboratories, L.P. | $168,162 |
| PFIZER INC. | $144 |
| Incyte Corporation | $70 |
| E.R. Squibb & Sons, L.L.C. | $60 |
| Lilly USA, LLC | $58 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-09-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190912001669 | I | Dermatology | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 365 | 60 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 205 | 142 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 122 | 89 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 93 | 74 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 85 | 64 | $0 |
Insurance plans in this area (ZIP 95816)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | CA | |
| Physician Assistant | CA | |
| Nurse Practitioner | CA | |
| Physician Assistant | CA | |
| D E R M A T O L O G Y | CA |
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