JEFFREY THOMAS II GARDNER – Dermatology Physician, NPI 1366901324
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
744 DERMATOLOGY in MA
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Provider Addresses for JEFFREY THOMAS II GARDNER
Massachusetts General Hospital, 55, Fruit Street, Beacon Hill, Boston, Suffolk County, Massachusetts, 02114, United States
BOSTON, MA 021142621
Phone:
Type: Mailing
1250 E 66th St
Savannah, GA 314045704
Phone: (800) 637-2378
Type: Location
55 Fruit St
Boston, MA 02114
Phone: (617) 726-2000
Type: Location
11234 Anderson St # C
Loma Linda, CA 923542804
Phone: (909) 558-2890
Type: Location
2383 PATE ST N
SNELLVILLE, GA 300783250
Phone: (770) 972-4845
Fax: (770) 972-0358
Type: Mailing
11234 ANDERSON ST # C
LOMA LINDA, CA 923542804
Phone: (909) 558-2890
Type: Mailing
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 $36.
Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.
Last reported payment date: 2024-11-06 • Largest payer in this snapshot: MIMEDX Group, Inc. ($20).
Total Amount
$36
General + Research + Ownership
Payments
2
Total payment records
General Amount
$36
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| MIMEDX Group, Inc. | $20 |
| ABBVIE INC. | $16 |
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: 2024-10-08
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 |
|---|---|---|---|---|
| I20240110002890 | I | Dermatology | CA | TBD |
| I20241008000045 | I | Dermatology | GA | 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 02114)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | GA | |
| D E R M A T O L O G Y | LA | |
| Physician Assistant | GA | |
| - | GA | |
| Nurse Practitioner | GA | |
| - | GA | |
| D E R M A T O L O G Y | GA | |
| Physician Assistant | GA | |
| Pathology, Dermatology | GA | |
| D E R M A T O L O G Y | GA |
Reviews
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