GRACE AYANDIBU (M.D, M.S, LPC) – Procedural Dermatology Physician, NPI 1023395928
Procedural Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
607 DERMATOLOGY in OH
Provider Addresses for GRACE AYANDIBU (M.D, M.S, LPC)
1044 BELMONT AVE
YOUNGSTOWN, OH 445041006
Phone: (330) 480-3196
Type: Mailing
2637 PLAZA PKWY
WICHITA FALLS, TX 763083889
Phone: (940) 239-9160
Type: Location
2637 Plaza Pkwy
Wichita Falls, TX 763083889
Phone: (940) 666-3060
Type: Location
4327 BARNETT RD
WICHITA FALLS, TX 763102303
Phone: (940) 687-3376
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 20 Open Payments records for all available years, with a total value of $408.
Total Amount is formed as General ($408) + Research ($0) + Ownership ($0) = $408.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($135).
Total Amount
$408
General + Research + Ownership
Payments
20
Total payment records
General Amount
$408
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Regeneron Healthcare Solutions, Inc. | $135 |
| E.R. Squibb & Sons, L.L.C. | $62 |
| Lilly USA, LLC | $59 |
| ABBVIE INC. | $38 |
| Biofrontera Inc. | $37 |
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: 2023-02-28
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 |
|---|---|---|---|---|
| I20230228000455 | I | Dermatology | TX | 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 | 1,520 | 260 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 440 | 440 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 357 | 296 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 205 | 203 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 180 | 149 | $0 |
Insurance plans in this area (ZIP 44504)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Dermatology, Micrographic Dermatologic Surgery (Mds) | TX |
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