DR. KENNETH MARK ELLNER (M.D.) – Dermatology Physician, NPI 1447259577
Dermatology Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
409 DERMATOLOGY in GA
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Provider Addresses for DR. KENNETH MARK ELLNER (M.D.)
1265, Upper Hembree Road, Roswell, Fulton, Georgia, 30076, United States
SUITE 100
ROSWELL, GA 300761143
Phone: (770) 750-1133
Fax: (770) 751-7410
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 202 Open Payments records for all available years, with a total value of $3,577.
Total Amount is formed as General ($3,577) + Research ($0) + Ownership ($0) = $3,577.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($1,044).
Total Amount
$3,577
General + Research + Ownership
Payments
202
Total payment records
General Amount
$3,577
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $1,044 |
| E.R. Squibb & Sons, L.L.C. | $383 |
| Arcutis Biotherapeutics, Inc. | $334 |
| Dermavant Sciences, Inc. | $233 |
| Janssen Biotech, Inc. | $221 |
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: 2005-06-14
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 |
|---|---|---|---|---|
| I20050614000637 | 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 | 1,680 | 310 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1,066 | 782 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 613 | 453 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 332 | 303 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 245 | 222 | $0 |
Insurance plans in this area (ZIP 30076)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | GA | 11101 | Biopsy of each additional growth of skin and/or tissue | 42 | 36 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | 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 | |
| D E R M A T 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 | |
| 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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