WINFRED DERRICK MOODY (MD) – Dermatology Physician, NPI 1124000187
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
409 DERMATOLOGY in GA
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Provider Addresses for WINFRED DERRICK MOODY (MD)
2295 CAPE COURAGE WAY
SUWANEE, GA 300242760
Phone: (678) 371-8167
Fax: (678) 376-8983
Type: Mailing
565, Old Norcross Road, Lawrenceville, Gwinnett County, Georgia, 30046, United States
SUITE #200
LAWRENCEVILLE, GA 300464308
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 38 Open Payments records for all available years, with a total value of $471.
Total Amount is formed as General ($471) + Research ($0) + Ownership ($0) = $471.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($388).
Total Amount
$471
General + Research + Ownership
Payments
38
Total payment records
General Amount
$471
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $388 |
| Janssen Biotech, Inc. | $83 |
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: 2004-12-17
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 |
|---|---|---|---|---|
| I20041217000139 | 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 | 233 | 25 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 109 | 59 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 47 | 39 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 44 | 31 | $0 |
| 11103 | Biopsy of related skin growth, each additional growth | 43 | 22 | $0 |
Insurance plans in this area (ZIP 30024)
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Provider's Procedures
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