JENNIFER B. SISSOM (PA) – Physician Assistant, NPI 1063488708
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for JENNIFER B. SISSOM (PA)
758 Old Norcross Rd
Suite 100
Lawrenceville, GA 300453385
Phone: (770) 962-4300
Fax: (770) 339-7544
Type: Location
2383, Pate Street North, Snellville, Gwinnett County, Georgia, 30078, United States
SNELLVILLE, GA 300783250
Phone: (770) 972-4845
Type: Location
1609 MAPMAKER DR
DACULA, GA 300197818
Phone: (404) 788-4321
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 303 Open Payments records for all available years, with a total value of $5,522.
Total Amount is formed as General ($5,522) + Research ($0) + Ownership ($0) = $5,522.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: ABBVIE INC. ($1,627).
Total Amount
$5,522
General + Research + Ownership
Payments
303
Total payment records
General Amount
$5,522
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $1,627 |
| GENZYME CORPORATION | $516 |
| E.R. Squibb & Sons, L.L.C. | $447 |
| LEO Pharma Inc. | $236 |
| Janssen Biotech, Inc. | $230 |
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: 2004-08-02
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 |
|---|---|---|---|---|
| I20040802000043 | I | Physician Assistant | 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 | 2,461 | 360 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 965 | 597 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 758 | 464 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 584 | 439 | $0 |
| 11103 | Biopsy of related skin growth, each additional growth | 322 | 184 | $0 |
Insurance plans in this area (ZIP 30045)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | GA | 11101 | Biopsy of each additional growth of skin and/or tissue | 164 | 109 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | GA | |
| D E R M A T O L O G Y | LA | |
| - | GA | |
| Nurse Practitioner | GA | |
| - | GA | |
| D E R M A T O L O G Y | GA | |
| D E R M A T O L O G Y | MA | |
| Physician Assistant | GA | |
| Pathology, Dermatology | GA | |
| D E R M A T O L O G Y | GA |
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