DR. NIKOLAI KLEBANOV (MD) – Dermatology Physician, NPI 1386202158
Dermatology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
744 DERMATOLOGY in MA
Provider Addresses for DR. NIKOLAI KLEBANOV (MD)
680 Centre St
Brockton, MA 023023308
Phone: (508) 941-7000
Type: Location
41 Mall Road
Burlington, MA 018053308
Phone: (781) 744-8000
Type: Location
Signature Healthcare Brockton Hospital, 680, Centre Street, Brockton, Plymouth County, Massachusetts, 02302, United States
BROCKTON, MA 023023308
Phone: (508) 941-7000
Type: Location
900 CUMMINGS CTR STE 311T
BEVERLY, MA 019156260
Phone: (978) 225-3376
Fax: (978) 560-1245
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $993.
Total Amount is formed as General ($993) + Research ($0) + Ownership ($0) = $993.
Last reported payment date: 2024-06-07 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($368).
Total Amount
$993
General + Research + Ownership
Payments
11
Total payment records
General Amount
$993
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| E.R. Squibb & Sons, L.L.C. | $368 |
| Janssen Biotech, Inc. | $205 |
| Dermavant Sciences, Inc. | $148 |
| ABBVIE INC. | $124 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $83 |
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: 2023-07-10
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 |
|---|---|---|---|---|
| I20230710002250 | 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 | 416 | 83 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 113 | 111 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 108 | 106 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 79 | 74 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 73 | 73 | $0 |
Insurance plans in this area (ZIP 02302)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MA | |
| - | MA | |
| G A S T R O E N T E R O L O G Y | NY | |
| Physician Assistant | MA | |
| A N E S T H E S I O L O G Y | MA |
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