DR. TIVON ISAAC SIDORSKY (MD, MBA, FAAD) – Dermatology Physician, NPI 1285952846
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
744 DERMATOLOGY in MA
Provider Addresses for DR. TIVON ISAAC SIDORSKY (MD, MBA, FAAD)
1 SCOBEE CIR STE 3
PLYMOUTH, MA 023604887
Phone: (508) 747-0711
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 191 Open Payments records for all available years, with a total value of $4,175.
Total Amount is formed as General ($4,175) + Research ($0) + Ownership ($0) = $4,175.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: ABBVIE INC. ($1,453).
Total Amount
$4,175
General + Research + Ownership
Payments
191
Total payment records
General Amount
$4,175
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 |
|---|---|
| ABBVIE INC. | $1,453 |
| E.R. Squibb & Sons, L.L.C. | $415 |
| Dermavant Sciences, Inc. | $349 |
| Janssen Biotech, Inc. | $295 |
| LEO Pharma Inc. | $259 |
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: 2014-08-07
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 |
|---|---|---|---|---|
| I20140807002153 | I | Dermatology | MA | 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 | 5,276 | 881 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 1,756 | 1,168 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1,539 | 1,091 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1,078 | 724 | $0 |
| 96900 | Application of ultraviolet light to skin | 824 | 17 | $0 |
Insurance plans in this area (ZIP 02360)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | MA | 11101 | Biopsy of each additional growth of skin and/or tissue | 404 | 196 |
| DERMATOLOGY | MA | 13132 | Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 38 | 34 |
| DERMATOLOGY | MA | 17003 | Destruction of 2-14 skin growths | 2312 | 368 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MA | |
| Nurse Practitioner | NY | |
| D E R M A T O L O G Y | OH | |
| D E R M A T O L O G Y | MA | |
| D E R M A T O L O G Y | MA | |
| D E R M A T O L O G Y | MA | |
| - | MA | |
| Pathology, Dermatology | MA | |
| Nurse Practitioner | MA | |
| D E R M A T O L O G Y | MA |
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