BRUMMITTE DALE WILSON (M.D.) – MOHS-Micrographic Surgery Physician, NPI 1245237288
MOHS-Micrographic Surgery Physician
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NPPES metrics only — not quality of care.
1,384 DERMATOLOGY in NY
Provider Addresses for BRUMMITTE DALE WILSON (M.D.)
17 LONG AVE STE 200
HAMBURG, NY 140756200
Phone: (716) 648-2770
Fax: (716) 646-4642
Type: Location
17, Long Avenue, Hamburg, Erie County, New York, 14075, United States
SUITE 200
HAMBURG, NY 140756200
Phone: (716) 648-2770
Fax: (716) 646-4642
Type: Mailing
425 Essjay Rd Ste 108
Williamsville, NY 142215782
Phone: (716) 630-1000
Fax: (716) 648-1552
Type: Location
85 High St
Buffalo, NY 142031194
Phone: (716) 630-1000
Fax: (716) 648-1552
Type: Location
325 Essjay Rd
Williamsville, NY 142218243
Phone: (716) 630-1000
Fax: (716) 684-1552
Type: Location
17 Long Ave Ste 200
Hamburg, NY 140756200
Phone: (716) 648-2770
Fax: (716) 646-4642
Type: Location
3900 N BUFFALO ST
ORCHARD PARK, NY 141271842
Phone: (716) 656-4494
Fax: (716) 648-1552
Type: Location
425 ESSJAY RD STE 170
WILLIAMSVILLE, NY 142218235
Phone: (716) 630-1219
Fax: (716) 817-1726
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $302.
Total Amount is formed as General ($302) + Research ($0) + Ownership ($0) = $302.
Last reported payment date: 2024-08-01 • Largest payer in this snapshot: Sun Pharmaceutical Industries Inc. ($148).
Total Amount
$302
General + Research + Ownership
Payments
9
Total payment records
General Amount
$302
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-01
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2009-12-11
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 |
|---|---|---|---|---|
| I20091211000501 | I | Dermatology | NY | 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 | 451 | 70 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 212 | 161 | $0 |
| 17311 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | 199 | 170 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 133 | 89 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 100 | 74 | $0 |
Insurance plans in this area (ZIP 14075)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | NY | 17003 | Destruction of 2-14 skin growths | 929 | 164 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Hematology/Oncology, Medical Oncology | NY | |
| Physician Assistant | NY | |
| Physician Assistant | NY | |
| - | NY | |
| Internal Medicine | NY | |
| Medical Oncology, Hematology | NY | |
| Physician Assistant | NY | |
| Nurse Practitioner | NY | |
| - | NY | |
| - | NY |
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