Unknown Individual – Dermatology Physician, NPI 1902807365
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1, Oakhurst Road, Wewoka, Seminole County, Oklahoma, 74884, United States
SEMINOLE, FL 337762112
Phone: (727) 517-3376
Fax: (727) 517-3370
Type: Location
4200, North Armenia Avenue, Tampa, Hillsborough County, Florida, 33607, United States
SUITE 1
TAMPA, FL 336076438
Phone: (813) 877-4811
Fax: (813) 872-8978
Type: Mailing
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 $117.
Total Amount is formed as General ($117) + Research ($0) + Ownership ($0) = $117.
Last reported payment date: 2024-07-16 • Largest payer in this snapshot: Arcutis Biotherapeutics, Inc. ($38).
Total Amount
$117
General + Research + Ownership
Payments
5
Total payment records
General Amount
$117
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Arcutis Biotherapeutics, Inc. | $38 |
| Amgen Inc. | $30 |
| LEO Pharma Inc. | $27 |
| Dermavant Sciences, Inc. | $21 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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 | 793 | 164 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 720 | 435 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 418 | 261 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 361 | 257 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 243 | 166 | $0 |
Insurance plans in this area (ZIP 33776)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| - | FL | |
| D E R M A T O L O G Y | FL |
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