MICHAEL TASSAVOR (MD) – Dermatology Physician, NPI 1043707003
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
38 MICROGRAPHIC DERMATOLOGIC SURGERY (MDS) in MA
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Provider Addresses for MICHAEL TASSAVOR (MD)
Lemuel Shattuck Hospital, 170, Morton Street, Forest Hills, Jamaica Plain, Boston, Suffolk County, Massachusetts, 02131, United States
JAMAICA PLAIN, MA 021303735
Phone: (860) 977-3678
Type: Location
3024 BURNET AVE
CINCINNATI, OH 452192420
Phone: (513) 221-2828
Fax: (513) 872-5721
Type: Location
140, Ten Rod Highway, Rocky Hill, Hartford County, Connecticut, 06067, United States
ROCKY HILL, CT 060672849
Phone: (212) 659-9530
Type: Mailing
820 2ND AVE RM 3A
NEW YORK, NY 100174534
Phone: (212) 661-3376
Fax: (212) 661-3366
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 184 Open Payments records for all available years, with a total value of $5,545.
Total Amount is formed as General ($5,545) + Research ($0) + Ownership ($0) = $5,545.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($900).
Total Amount
$5,545
General + Research + Ownership
Payments
184
Total payment records
General Amount
$5,545
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| E.R. Squibb & Sons, L.L.C. | $900 |
| LEO Pharma Inc. | $851 |
| Arcutis Biotherapeutics, Inc. | $596 |
| Janssen Biotech, Inc. | $562 |
| PFIZER INC. | $331 |
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: 2023-05-12
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 |
|---|---|---|---|---|
| I20230502001456 | I | Micrographic Dermatologic Surgery (Mds) | NJ | TBD |
| I20230512001296 | I | Micrographic Dermatologic Surgery (Mds) | NY | 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 | 366 | 78 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 179 | 163 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 139 | 122 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 122 | 114 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 121 | 115 | $0 |
Insurance plans in this area (ZIP 02130)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | NY | |
| D E R M A T O L O G Y | IL |
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