NICHOLAS BLICKENSTAFF (M.D., M.S.) – Dermatology Physician, NPI 1437544582
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
703 DERMATOLOGY in IL
Provider Addresses for NICHOLAS BLICKENSTAFF (M.D., M.S.)
30 N MICHIGAN AVE STE 1429
CHICAGO, IL 606023698
Phone: (815) 744-8554
Type: Location
13176 W Persimmon Ln
Boise, ID 837135063
Phone: (208) 939-8640
Fax: (208) 939-1892
Type: Location
7123 W ARCHER AVE
CHICAGO, IL 606382203
Phone: (708) 634-4602
Fax: (630) 495-1770
Type: Mailing
6454 W EMERALD ST
BOISE, ID 837048734
Phone: (208) 377-0820
Fax: (208) 375-8046
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 58 Open Payments records for all available years, with a total value of $2,014.
Total Amount is formed as General ($2,014) + Research ($0) + Ownership ($0) = $2,014.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: ABBVIE INC. ($518).
Total Amount
$2,014
General + Research + Ownership
Payments
58
Total payment records
General Amount
$2,014
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $518 |
| Janssen Biotech, Inc. | $356 |
| Galderma Laboratories, L.P. | $254 |
| Novartis Pharmaceuticals Corporation | $153 |
| Dermavant Sciences, Inc. | $144 |
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: 2021-08-11
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 |
|---|---|---|---|---|
| I20201117002192 | I | Dermatology | IN | TBD |
| I20210811002368 | I | Dermatology | ID | 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 | 1,970 | 337 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 633 | 461 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 618 | 441 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 275 | 233 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 166 | 139 | $0 |
Insurance plans in this area (ZIP 60602)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MA | |
| Physician Assistant | ID | |
| - | ID | |
| Physician Assistant | ID | |
| Physician Assistant | ID |
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