SULTAN MIRZA (M.D.) – Dermatology Physician, NPI 1790196699
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,366 DERMATOLOGY in FL
Provider Addresses for SULTAN MIRZA (M.D.)
4651 VAN DYKE RD
LUTZ, FL 335584880
Phone: (813) 321-1786
Fax: (813) 321-1787
Type: Mailing
32615 US HIGHWAY 19 N STE 1
PALM HARBOR, FL 346843176
Phone: (813) 321-1786
Fax: (813) 321-1787
Type: Location
1025 MARSH ST
MANKATO, MN 560014752
Phone: (507) 625-4031
Type: Mailing
25097 Olympia Ave Ste 202
Punta Gorda, FL 339503914
Phone: (813) 321-1786
Fax: (813) 321-1787
Type: Location
14095 Cortez Blvd
Brooksville, FL 346135794
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 5 Open Payments records for all available years, with a total value of $124.
Total Amount is formed as General ($124) + Research ($0) + Ownership ($0) = $124.
Last reported payment date: 2024-05-21 • Largest payer in this snapshot: Organogenesis Inc. ($44).
Total Amount
$124
General + Research + Ownership
Payments
5
Total payment records
General Amount
$124
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organogenesis Inc. | $44 |
| Regeneron Healthcare Solutions, Inc. | $26 |
| ConvaTec Inc. | $19 |
| ABBVIE INC. | $19 |
| Sun Pharmaceutical Industries Inc. | $16 |
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: 2018-06-21
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 |
|---|---|---|---|---|
| I20150728005841 | I | Dermatology | MN | TBD |
| I20180621002689 | 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 | 974 | 236 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 956 | 625 | $0 |
| 17311 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | 622 | 453 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 590 | 376 | $0 |
| 17312 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks | 567 | 338 | $0 |
Insurance plans in this area (ZIP 33558)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| Nurse Practitioner | FL | |
| D E R M A T O L O G Y | FL | |
| - | FL | |
| Physician Assistant | FL | |
| D E R M A T O L O G Y | FL | |
| Nurse Practitioner | FL | |
| Physician Assistant | FL | |
| Dermatology, Micrographic Dermatologic Surgery (Mds) | FL | |
| Physician Assistant | FL |
Reviews
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