MS. TRACY R. ENNIS (PA-C) – Dermatology Physician, NPI 1003121609
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
Provider Addresses for MS. TRACY R. ENNIS (PA-C)
2235 VENETIAN COURT
SUITE 1
NAPLES, FL 341098728
Phone: (239) 596-9337
Fax: (239) 596-9466
Type: Mailing
PO BOX 23964
TAMPA, FL 336233964
Phone: (239) 263-0849
Fax: (239) 263-2376
Type: Mailing
6101 PINE RIDGE RD
1ST FLOOR- DESK 12/13
NAPLES, FL 341193900
Phone: (239) 263-0849
Fax: (239) 263-2376
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 51 Open Payments records for all available years, with a total value of $1,292.
Total Amount is formed as General ($1,292) + Research ($0) + Ownership ($0) = $1,292.
Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Janssen Biotech, Inc. ($263).
Total Amount
$1,292
General + Research + Ownership
Payments
51
Total payment records
General Amount
$1,292
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-20
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: 2016-05-19
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 |
|---|---|---|---|---|
| I20160519001473 | I | Physician Assistant | FL | 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 | 441 | 124 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 331 | 289 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 256 | 219 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 211 | 200 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 183 | 168 | $0 |
Insurance plans in this area (ZIP 34109)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NC | |
| D E R M A T O L O G Y | PR | |
| P A T H O L O G Y | FL | |
| D E R M A T O L O G Y | FL | |
| Micrographic Dermatologic Surgery (Mds) | NY | |
| - | FL | |
| - | FL | |
| Micrographic Dermatologic Surgery (Mds) | FL | |
| Otolaryngology, Plastic And Reconstructive Surgery | FL | |
| D E R M A T O L O G Y | FL |
Reviews
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