STUART HOLLAND BERRYMAN (PA-C) – Medical Physician Assistant, NPI 1093774705
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
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Provider Addresses for STUART HOLLAND BERRYMAN (PA-C)
4909, North Glen Park Pl Road, Peoria, Peoria County, Illinois, 61614, United States
PEORIA, IL 616144676
Phone: (309) 674-7546
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 26 Open Payments records for all available years, with a total value of $542.
Total Amount is formed as General ($542) + Research ($0) + Ownership ($0) = $542.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Sun Pharmaceutical Industries Inc. ($218).
Total Amount
$542
General + Research + Ownership
Payments
26
Total payment records
General Amount
$542
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2010-06-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20071130000507 | I | Physician Assistant | IL | TBD |
| I20100622000104 | I | Physician Assistant | IA | 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 | 4,124 | 595 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 2,222 | 1,498 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 1,089 | 767 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 453 | 356 | $0 |
| 17004 | Destruction of precancer skin growth, 15 or more growths | 174 | 121 | $0 |
Insurance plans in this area (ZIP 61614)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | IL | 17003 | Destruction of 2-14 skin growths | 2342 | 313 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| D E R M A T O L O G Y | IL | |
| Plastic And Reconstructive Surgery | IL | |
| D E R M A T O L O G Y | IA | |
| - | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| P A T H O L O G Y | IL | |
| Physician Assistant | IL | |
| - | CA |
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