MATTHEW DAVIS (MD) – Student in an Organized Health Care Education/Training Program, NPI 1780200253
Student in an Organized Health Care Education/Training Program
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
337 DERMATOLOGY in MO
Provider Addresses for MATTHEW DAVIS (MD)
615 S NEW BALLAS RD
SAINT LOUIS, MO 631418221
Phone: (314) 251-6930
Type: Location
17206 HILLCREST RIDGE DR
CHESTERFIELD, MO 630051328
Phone: (813) 486-8923
Type: Mailing
1 MEDICAL CENTER DR
LEBANON, NH 037561000
Phone: (603) 650-5000
Type: Location
PO BOX 810
HANOVER, NH 037550810
Phone: (603) 308-1472
Type: Mailing
HELIX: 30 N MARIO CAPECCHI RM 1S100
SALT LAKE CITY, UT 84112
Phone: (801) 581-2121
Type: Location
1 Medical Center Dr
Lebanon, NH 037561000
Phone: (603) 650-5000
Fax: (603) 640-1228
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $87.
Total Amount is formed as General ($87) + Research ($0) + Ownership ($0) = $87.
Last reported payment date: 2024-09-11 • Largest payer in this snapshot: Galderma Laboratories, L.P. ($87).
Total Amount
$87
General + Research + Ownership
Payments
1
Total payment records
General Amount
$87
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Galderma Laboratories, L.P. | $87 |
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: 2025-09-18
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20240726002659 | I | Dermatology | UT | TBD |
| I20250918003203 | I | Dermatology | NH | 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 63141)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | UT | |
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | TN | |
| D E R M A T O L O G Y | CA | |
| P A T H O L O G Y | UT | |
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | PA | |
| - | UT |
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