SUPRIYA IMMANENI (MD) – MOHS-Micrographic Surgery Physician, NPI 1497129399
MOHS-Micrographic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
703 DERMATOLOGY in IL
Provider Addresses for SUPRIYA IMMANENI (MD)
240 E HURON ST
SUITE 1-200
CHICAGO, IL 606112909
Phone: (312) 503-7975
Type: Mailing
308 COLISEUM DR
ST 200
MACON, GA 312173865
Phone: (478) 742-2180
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 64 Open Payments records for all available years, with a total value of $1,667.
Total Amount is formed as General ($1,667) + Research ($0) + Ownership ($0) = $1,667.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($600).
Total Amount
$1,667
General + Research + Ownership
Payments
64
Total payment records
General Amount
$1,667
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
| Company | Amount |
|---|---|
| Regeneron Healthcare Solutions, Inc. | $600 |
| ABBVIE INC. | $459 |
| Janssen Biotech, Inc. | $222 |
| Novartis Pharmaceuticals Corporation | $88 |
| Incyte Corporation | $62 |
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: 2023-07-13
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 |
|---|---|---|---|---|
| I20230713000227 | I | Micrographic Dermatologic Surgery (Mds) | 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 | 311 | 68 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 100 | 87 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 100 | 89 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 89 | 84 | $0 |
| 11103 | Biopsy of related skin growth, each additional growth | 68 | 38 | $0 |
Insurance plans in this area (ZIP 60611)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| D E R M A T O L O G Y | GA | |
| D E R M A T O L O G Y | NY | |
| Dermatology, Micrographic Dermatologic Surgery (Mds) | GA | |
| D E R M A T O L O G Y | MN | |
| Physician Assistant | GA | |
| D E R M A T O L O G Y | GA | |
| Physician Assistant | GA | |
| D E R M A T O L O G Y | GA |
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