DR. PETER THEOHARIDIS (D.M.D.) – Oral and Maxillofacial Pathology Dentistry, NPI 1831176494
Oral and Maxillofacial Pathology Dentistry
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. PETER THEOHARIDIS (D.M.D.)
241, Station Avenue, South Yarmouth, Yarmouth, Barnstable County, Massachusetts, 02664, United States
SOUTH YARMOUTH, MA 026641863
Phone: (508) 398-6055
Fax: (508) 398-7228
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 27 Open Payments records for all available years, with a total value of $1,008.
Total Amount is formed as General ($1,008) + Research ($0) + Ownership ($0) = $1,008.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: ZIMVIE INC. ($724).
Total Amount
$1,008
General + Research + Ownership
Payments
27
Total payment records
General Amount
$1,008
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ZIMVIE INC. | $724 |
| Keystone Dental Inc. | $284 |
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: 2007-11-08
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 |
|---|---|---|---|---|
| I20071108000516 | I | Oral Surgery | 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 02664)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Oral Surgery | MA | |
| Oral Surgery | GA |
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