MICHAEL L DERN (MD) – Family Medicine Physician, NPI 1710968136
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MICHAEL L DERN (MD)
110, Liberty Street, Marshall Corner, Brockton, Plymouth County, Massachusetts, 02357, United States
BROCKTON, MA 023015521
Phone: (508) 894-0400
Fax: (508) 565-0157
Type: Mailing
360 BROCKTON AVE
ABINGTON, MA 023512186
Phone: (781) 878-1700
Fax: (508) 894-0412
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2005-03-24
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 |
|---|---|---|---|---|
| I20050324000743 | I | Family Practice | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 02301)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | MA | 83036 | Hemoglobin A1C level | 46 | 37 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MA | |
| General Surgery | IL | |
| E N D O C R I N O L O G Y | MI | |
| - | CA | |
| Internal Medicine | MA | |
| - | NY | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MA | |
| - | MA | |
| Orthopedic Surgery | MA | |
| - | NY |
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