DR. RICHARD THOMAS ETHRIDGE (MD) – Plastic and Reconstructive Surgery Physician, NPI 1013108299
Plastic and Reconstructive Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
112 PLASTIC AND RECONSTRUCTIVE SURGERY in CO
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Provider Addresses for DR. RICHARD THOMAS ETHRIDGE (MD)
Poudre River Drive, Fort Collins, Larimer County, Colorado, 80524-3233, United States
FORT COLLINS, CO 805243557
Phone: (970) 484-6303
Fax: (704) 843-0369
Type: Location
Southhall Lane, Maitland, Orange County, Florida, 32810, United States
MAITLAND, FL 327517172
Phone: (970) 484-6303
Fax: (970) 484-3036
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 72 Open Payments records for all available years, with a total value of $1,558.
Total Amount is formed as General ($1,558) + Research ($0) + Ownership ($0) = $1,558.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Lilly USA, LLC ($312).
Total Amount
$1,558
General + Research + Ownership
Payments
72
Total payment records
General Amount
$1,558
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2020-01-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20080930000812 | I | Plastic And Reconstructive Surgery | TX | TBD |
| I20200116002026 | I | Plastic And Reconstructive Surgery | CO | 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 |
|---|---|---|---|---|
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 303 | 303 | $0 |
| 13132 | Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm | 285 | 252 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 152 | 130 | $0 |
| 14040 | Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less | 143 | 135 | $0 |
| 13121 | Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm | 114 | 107 | $0 |
Insurance plans in this area (ZIP 80524)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CO | |
| Nurse Practitioner | CA | |
| Physician Assistant | NE | |
| Nurse Practitioner | TN | |
| Physician Assistant | CO | |
| Nurse Practitioner | CO | |
| D E R M A T O L O G Y | CO | |
| - | TX | |
| Physician Assistant | CO | |
| - | CO |
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