COLLEEN RENEE MACINNIS (MD) – Dermatology Physician, NPI 1700828290
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,366 DERMATOLOGY in FL
Provider Addresses for COLLEEN RENEE MACINNIS (MD)
17521 US Highway 441 Ste 21
Mount Dora, FL 327576737
Phone: (813) 321-1786
Fax: (813) 321-1787
Type: Location
4120, Corley Island Road, Leesburg, Lake County, Florida, 34748, United States
SUITE 600
LEESBURG, FL 347488292
Phone: (352) 350-5230
Fax: (866) 539-7193
Type: Location
18228 N US HIGHWAY 41
LUTZ, FL 335494400
Phone: (813) 321-1786
Fax: (813) 321-1787
Type: Mailing
27950 US HIGHWAY 27
LEESBURG, FL 347489050
Phone: (813) 321-1786
Fax: (813) 321-1787
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $93.
Total Amount is formed as General ($93) + Research ($0) + Ownership ($0) = $93.
Last reported payment date: 2024-08-06 • Largest payer in this snapshot: Kerecis Limited ($40).
Total Amount
$93
General + Research + Ownership
Payments
4
Total payment records
General Amount
$93
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Kerecis Limited | $40 |
| ABBVIE INC. | $34 |
| Almirall LLC | $19 |
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: 2007-12-19
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 |
|---|---|---|---|---|
| I20071219000781 | I | Dermatology | 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 | 434 | 91 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 202 | 177 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 136 | 129 | $0 |
| 17311 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | 120 | 109 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 95 | 92 | $0 |
Insurance plans in this area (ZIP 32757)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | FL | 13132 | Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 146 | 132 |
| DERMATOLOGY | FL | 14060 | Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips | 54 | 53 |
| DERMATOLOGY | FL | 17003 | Destruction of 2-14 skin growths | 2479 | 500 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Dermatology, Micrographic Dermatologic Surgery (Mds) | FL | |
| Nurse Practitioner | FL | |
| - | TX | |
| Physician Assistant | FL | |
| Physician Assistant | FL | |
| D E R M A T O L O G Y | FL | |
| Physician Assistant | FL |
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