JOHNNY GURGEN (D.O.) – Dermatology Physician, NPI 1962666966

JOHNNY GURGEN (D.O.) is a healthcare provider. based in Leesburg, Florida. specializing in DERMATOLOGY. They hold the professional credentials D.O.. They hold a License No. OS10423 (FL). The NPI Number for JOHNNY GURGEN (D.O.) is 1962666966

Main info

Male
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
JOHNNY GURGEN (D.O.)
NPI
1962666966
Phone
(352) 435-7695
Address
1340 Citizens Blvd
Enumeration Date
18 July 2008
Last Update Date
11 June 2019

Doctor Profile

Medical School Name
OAKLAND COLLEGE OF MEDICINE AND SURGERY
Secondary Phone
3524357695
Graduation Year
2006 (20 years ago)
PAC ID
2264556331
Group Practice PAC ID
1355504861
Professional Enrollment ID
I20100825001007
Address ID
FL321595029LA920XXRDXX403
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:17State licenses:1Digital endpointsOther names

1,369 DERMATOLOGY in FL

Provider Addresses for JOHNNY GURGEN (D.O.)

  • 1340 Citizens Blvd

    Leesburg, FL 347483924

    Phone: (352) 435-7695

    Type: Location

  • 920 ROLLING ACRES RD UNIT 203

    LADY LAKE, FL 321595029

    Phone: (352) 435-7695

    Fax: (352) 435-7453

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 16 Open Payments records for all available years, with a total value of $351.

Total Amount is formed as General ($351) + Research ($0) + Ownership ($0) = $351.

Last reported payment date: 2024-11-13 • Largest payer in this snapshot: Organogenesis Inc. ($79).

Total Amount

$351

General + Research + Ownership

Payments

16

Total payment records

General Amount

$351

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-13

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2010-08-25

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100825001007IDermatologyFLTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
77401Superficial and/or low voltage radiation treatment delivery7,806449$0
88305Pathology examination of tissue using a microscope, intermediate complexity3,9061,285$0
77280Obtaining data needed to develop the optimal radiation treatment, 1 treatment area2,546409$0
99213Established patient office or other outpatient visit, 20-29 minutes1,211377$0
77300Calculation of radiation therapy dose564406$0
View full utilization report →

Insurance plans in this area (ZIP 34748)

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Provider's Procedures

JOHNNY GURGEN (D.O.) performs procedures in DERMATOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYFL17003Destruction of 2-14 skin growths29366

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355504861View full group profile
NameSpecialtyState
-FL
Physician AssistantFL
Physician AssistantIL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What NPI should I save for JOHNNY GURGEN (D.O.)?
Save NPI 1962666966 if you need a stable reference for JOHNNY GURGEN (D.O.).
Is JOHNNY GURGEN (D.O.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is JOHNNY GURGEN (D.O.)?
The page reflects Dermatology Physician for JOHNNY GURGEN (D.O.). Clinical services aligned with this taxonomy classification.
Where does public data place JOHNNY GURGEN (D.O.)?
The snapshot lists Leesburg, Florida for JOHNNY GURGEN (D.O.); download NPPES for the complete set.
How can I contact JOHNNY GURGEN (D.O.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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