LEE MICHAEL DE DORE (PA) – Surgical Physician Assistant, NPI 1790017085
Surgical 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 LEE MICHAEL DE DORE (PA)
Westbrook Corporate Center, Westchester, Proviso Township, Cook County, Illinois, United States
STE 240
WESTCHESTER, IL 601545745
Phone: (630) 682-5653
Fax: (630) 682-8946
Type: Mailing
Northwestern Medicine Central DuPage Hospital, 25, North Winfield Road, Geneva Road, Winfield, DuPage County, Illinois, 60190, United States
SUITE 505
WINFIELD, IL 60190
Phone: (630) 682-5653
Fax: (630) 682-8946
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $183.
Total Amount is formed as General ($183) + Research ($0) + Ownership ($0) = $183.
Last reported payment date: 2024-05-01 • Largest payer in this snapshot: Linvatec Corporation ($118).
Total Amount
$183
General + Research + Ownership
Payments
2
Total payment records
General Amount
$183
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-01
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Linvatec Corporation | $118 |
| Stryker Corporation | $65 |
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: 2015-04-16
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 |
|---|---|---|---|---|
| I20100617000810 | I | Physician Assistant | IL | TBD |
| I20150416002432 | I | Physician Assistant | IN | 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 |
|---|---|---|---|---|
| 73030 | X-ray of shoulder, minimum of 2 views | 41 | 32 | $0 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 24 | 12 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 18 | 17 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 17 | 16 | $0 |
Insurance plans in this area (ZIP 60154)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| A N E S T H E S I O L O G Y | IL | |
| Family Practice, Sports Medicine | IL | |
| Occupational Therapist In Private Practice | IL | |
| Physical Therapist In Private Practice | TN | |
| - | IL | |
| Physical Therapist In Private Practice | IL | |
| Physician Assistant | IL | |
| Physician Assistant | WI | |
| Physician Assistant | IL | |
| - | WI |
Reviews
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