JEREN ROBERT KOWALEWSKI (PA-C) – Dermatology Physician, NPI 1174153969
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JEREN ROBERT KOWALEWSKI (PA-C)
920 ROLLING ACRES RD UNIT 205
LADY LAKE, FL 321595029
Phone: (352) 633-7930
Fax: (352) 633-7924
Type: Mailing
1340 CITIZENS BLVD
LEESBURG, FL 347483924
Phone: (352) 435-7695
Type: Location
920 Rolling Acres Rd Unit 205
Lady Lake, FL 321595029
Phone: (352) 633-7930
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $181.
Total Amount is formed as General ($181) + Research ($0) + Ownership ($0) = $181.
Last reported payment date: 2024-10-15 • Largest payer in this snapshot: Organogenesis Inc. ($43).
Total Amount
$181
General + Research + Ownership
Payments
8
Total payment records
General Amount
$181
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-15
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: 2020-03-09
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 |
|---|---|---|---|---|
| I20200309000176 | 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 | 787 | 130 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 283 | 214 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 280 | 213 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 252 | 180 | $0 |
| 11103 | Biopsy of related skin growth, each additional growth | 234 | 116 | $0 |
Insurance plans in this area (ZIP 32159)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | FL | |
| Physician Assistant | IL | |
| Nurse Practitioner | FL | |
| D E R M A T O L O G Y | FL |
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