COURTNEY N BOLLUYT (PA-C) – Physician Assistant, NPI 1215982780
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,649 PHYSICIAN ASSISTANT in IA
Provider Addresses for COURTNEY N BOLLUYT (PA-C)
2700 23RD ST STE C
SPIRIT LAKE, IA 513601158
Phone: (605) 330-9619
Type: Location
Gaul Dermatology, 2004, Highway Boulevard, Birchwood Estates, Spencer, Clay County, Iowa, 51301, United States
SPENCER, IA 51301
Phone: (712) 262-6906
Type: Mailing
4950 S MINNESOTA AVE
SIOUX FALLS, SD 571082708
Phone: (605) 330-9619
Fax: (605) 330-9503
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $125.
Total Amount is formed as General ($125) + Research ($0) + Ownership ($0) = $125.
Last reported payment date: 2024-12-05 • Largest payer in this snapshot: ABBVIE INC. ($55).
Total Amount
$125
General + Research + Ownership
Payments
6
Total payment records
General Amount
$125
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $55 |
| Organogenesis Inc. | $32 |
| E.R. Squibb & Sons, L.L.C. | $23 |
| Amgen Inc. | $15 |
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: 2004-08-19
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 |
|---|---|---|---|---|
| I20040819000067 | 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 | 2,455 | 706 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1,518 | 1,209 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 1,279 | 1,003 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 605 | 510 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 206 | 206 | $0 |
Insurance plans in this area (ZIP 51360)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | SD |
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