DR. DMITRIY M PELISHEV (D.O.) – Family Medicine Physician, NPI 1457400251
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,102 FAMILY PRACTICE in GA
Provider Addresses for DR. DMITRIY M PELISHEV (D.O.)
65 OLD JACKSON RD
MCDONOUGH, GA 302523095
Phone: (678) 490-0080
Fax: (678) 490-0091
Type: Mailing
65 Old Jackson Rd
McDonough, GA 302523095
Phone: (678) 490-0080
Fax: (678) 490-0091
Type: Location
3088 WASHINGTON RD
EAST POINT, GA 303444566
Phone: (470) 444-3135
Fax: (404) 777-9336
Type: Location
PO BOX 740015
ATLANTA, GA 303740015
Phone: (312) 773-9730
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $77.
Total Amount is formed as General ($77) + Research ($0) + Ownership ($0) = $77.
Last reported payment date: 2024-09-17 • Largest payer in this snapshot: Novo Nordisk Inc ($58).
Total Amount
$77
General + Research + Ownership
Payments
4
Total payment records
General Amount
$77
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $58 |
| Actelion Pharmaceuticals US, Inc. | $20 |
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: 2009-10-28
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 |
|---|---|---|---|---|
| I20091028000423 | I | Family Practice | 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 |
|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 27 | 20 | $0 |
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 16 | 16 | $0 |
Insurance plans in this area (ZIP 30252)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | GA | 85610 | Blood test, clotting time | 26 | 14 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA |
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