DR. JACK KRUSHELL (M.D.) – Dermatology Physician, NPI 1558328609
Dermatology Physician
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Profile Insights
NPPES metrics only — not quality of care.
744 DERMATOLOGY in MA
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Provider Addresses for DR. JACK KRUSHELL (M.D.)
Ivy Realty Group, 40, Holland Street, Davis Square, Somerville, Middlesex County, Massachusetts, 02144, United States
DERMATOLOGY DEPT.
SOMERVILLE, MA 021442705
Phone: (617) 629-6250
Fax: (617) 629-6108
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 6 Open Payments records for all available years, with a total value of $165.
Total Amount is formed as General ($165) + Research ($0) + Ownership ($0) = $165.
Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Janssen Biotech, Inc. ($70).
Total Amount
$165
General + Research + Ownership
Payments
6
Total payment records
General Amount
$165
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Biotech, Inc. | $70 |
| Smith+Nephew, Inc. | $43 |
| Lilly USA, LLC | $29 |
| E.R. Squibb & Sons, L.L.C. | $23 |
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: 2006-03-31
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 |
|---|---|---|---|---|
| I20060331000057 | 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 | 292 | 84 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 276 | 183 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 171 | 141 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 159 | 129 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 158 | 123 | $0 |
Insurance plans in this area (ZIP 02144)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | MA | 17003 | Destruction of 2-14 skin growths | 315 | 57 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MA | |
| Family Practice | MA | |
| D E R M A T O L O G Y | MA | |
| Emergency Medicine | MA | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | MA | |
| - | MA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MA | |
| - | MA | |
| Internal Medicine | MA | |
| O T O L A R Y N G O L O G Y | MA |
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