SUPRITHA NILAM (DDS) – Oral & Maxillofacial Surgery (D.M.D.), NPI 1629597562
Oral & Maxillofacial Surgery (D.M.D.)
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8 MAXILLOFACIAL SURGERY in ME
Provider Addresses for SUPRITHA NILAM (DDS)
72 Beechland Rd
Ellsworth, ME 046052533
Phone: (207) 667-6789
Type: Location
Stone Park Properties, 72, Beechland Road, Ellsworth, Hancock County, Maine, 04605, United States
ELLSWORTH, ME 046052533
Phone: (207) 667-6789
Type: Mailing
PO BOX 636256
CINCINNATI, OH 452636256
Phone: (513) 585-6200
Fax: (513) 245-3672
Type: Mailing
222 PIEDMONT AVE
CINCINNATI, OH 452194231
Phone: (513) 475-8783
Fax: (513) 475-7698
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 34 Open Payments records for all available years, with a total value of $2,420.
Total Amount is formed as General ($2,420) + Research ($0) + Ownership ($0) = $2,420.
Last reported payment date: 2024-11-23 • Largest payer in this snapshot: Stryker Corporation ($1,295).
Total Amount
$2,420
General + Research + Ownership
Payments
34
Total payment records
General Amount
$2,420
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Stryker Corporation | $1,295 |
| Medical Device Business Services, Inc. | $675 |
| KLS-Martin L.P. | $266 |
| AXOGEN | $184 |
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: 2025-09-11
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 |
|---|---|---|---|---|
| I20250911000407 | I | Maxillofacial Surgery | OH | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 04605)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Oral Surgery, Maxillofacial Surgery | OH | |
| Maxillofacial Surgery, Oral Surgery | OH | |
| Maxillofacial Surgery, Oral Surgery | OH | |
| Nurse Practitioner | OH | |
| - | MS | |
| Oral Surgery, Maxillofacial Surgery, Maxillofacial Surgery | OH | |
| Oral Surgery, Oral And Maxillofacial Pathology | NC | |
| D E N T I S T | AL | |
| - | OH | |
| Oral Surgery | OH |
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