KENYATTA MIREKU (MD) – Dermatology Physician, NPI 1740600048
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
409 DERMATOLOGY in GA
Provider Addresses for KENYATTA MIREKU (MD)
151 SOUTHHALL LN STE 300
MAITLAND, FL 327517172
Phone:
Type: Mailing
771 OLD NORCROSS RD STE 260
LAWRENCEVILLE, GA 300464981
Phone: (770) 962-5040
Fax: (770) 962-5056
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 301 Open Payments records for all available years, with a total value of $17,656.
Total Amount is formed as General ($17,656) + Research ($0) + Ownership ($0) = $17,656.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Galderma Laboratories, L.P. ($11,516).
Total Amount
$17,656
General + Research + Ownership
Payments
301
Total payment records
General Amount
$17,656
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Galderma Laboratories, L.P. | $11,516 |
| ABBVIE INC. | $1,115 |
| E.R. Squibb & Sons, L.L.C. | $623 |
| UCB, Inc. | $402 |
| Janssen Biotech, Inc. | $381 |
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: 2018-09-26
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 |
|---|---|---|---|---|
| I20180926003098 | I | Dermatology | GA | 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 | 649 | 135 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 267 | 218 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 263 | 188 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 246 | 186 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 163 | 148 | $0 |
Insurance plans in this area (ZIP 32751)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Dermatology, Micrographic Dermatologic Surgery (Mds) | FL | |
| D E R M A T O L O G Y | FL | |
| Physician Assistant | FL | |
| Physician Assistant | GA | |
| Dermatology, Micrographic Dermatologic Surgery (Mds) | GA | |
| D E R M A T O L O G Y | FL | |
| Physician Assistant | GA | |
| D E R M A T O L O G Y | FL | |
| Physician Assistant | GA | |
| Physician Assistant | FL |
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