NICOLE M. BOSSENBROEK (M.D.) – Dermatopathology Physician, NPI 1619909611
Dermatopathology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
532 DERMATOLOGY in MI
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Provider Addresses for NICOLE M. BOSSENBROEK (M.D.)
6225, Prairie Street, Norton Shores, Muskegon County, Michigan, 49444, United States
NORTON SHORES, MI 494447831
Phone: (231) 798-9500
Fax: (231) 798-9533
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 113 Open Payments records for all available years, with a total value of $2,368.
Total Amount is formed as General ($2,368) + Research ($0) + Ownership ($0) = $2,368.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: GENZYME CORPORATION ($363).
Total Amount
$2,368
General + Research + Ownership
Payments
113
Total payment records
General Amount
$2,368
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GENZYME CORPORATION | $363 |
| Regeneron Healthcare Solutions, Inc. | $243 |
| ABBVIE INC. | $235 |
| PFIZER INC. | $163 |
| SUN PHARMACEUTICAL INDUSTRIES INC. | $136 |
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: 2007-03-23
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 |
|---|---|---|---|---|
| I20070323000009 | I | Dermatology | MI | 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 |
|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 1,483 | 922 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 155 | 39 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 75 | 71 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 71 | 50 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 67 | 62 | $0 |
Insurance plans in this area (ZIP 49444)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | MI | 11101 | Biopsy of each additional growth of skin and/or tissue | 74 | 36 |
| DERMATOLOGY | MI | 17003 | Destruction of 2-14 skin growths | 178 | 45 |
| DERMATOLOGY | MI | 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 66 | 60 |
| DERMATOLOGY | MI | 88312 | Special stained specimen slides to identify organisms including interpretation and report | 164 | 119 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MI | |
| Nurse Practitioner | OH | |
| D E R M A T O L O G Y | TX | |
| D E R M A T O L O G Y | MI | |
| Dermatology, Micrographic Dermatologic Surgery (Mds) | OH | |
| Physician Assistant | MI |
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