DORA MCIVER BROOM (PA-C) – Physician Assistant, NPI 1144642844
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for DORA MCIVER BROOM (PA-C)
103 JOHN MADDOX DR NW
ROME, GA 301651419
Phone: (706) 235-7711
Fax: (706) 235-9944
Type: Mailing
100 STONEFOREST DR
SUITE 320
WOODSTOCK, GA 30189
Phone: (770) 516-5199
Type: Mailing
100 STONEFOREST DR STE 320
WOODSTOCK, GA 301894881
Phone: (770) 516-5199
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 336 Open Payments records for all available years, with a total value of $7,702.
Total Amount is formed as General ($7,702) + Research ($0) + Ownership ($0) = $7,702.
Last reported payment date: 2024-12-26 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($1,173).
Total Amount
$7,702
General + Research + Ownership
Payments
336
Total payment records
General Amount
$7,702
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| E.R. Squibb & Sons, L.L.C. | $1,173 |
| Dermavant Sciences, Inc. | $890 |
| ABBVIE INC. | $703 |
| GENZYME CORPORATION | $660 |
| Sun Pharmaceutical Industries Inc. | $308 |
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: 2015-03-27
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 |
|---|---|---|---|---|
| I20150327000484 | 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 | 742 | 136 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 262 | 222 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 215 | 187 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 76 | 69 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 50 | 50 | $0 |
Insurance plans in this area (ZIP 30165)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | GA | 17003 | Destruction of 2-14 skin growths | 2370 | 387 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | GA | |
| D E R M A T O L O G Y | TN | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| P A T H O L O G Y | GA | |
| D E R M A T O L O G Y | GA | |
| D E R M A T O L O G Y | GA |
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