DR. ALLISON J MOOSALLY (MD) – MOHS-Micrographic Surgery Physician, NPI 1104847334

DR. ALLISON J MOOSALLY (MD) is a healthcare provider. based in Mayfield hts, Ohio. specializing in DERMATOLOGY. They hold the professional credentials MD. They hold a License No. 35088136 (OH). The NPI Number for DR. ALLISON J MOOSALLY (MD) is 1104847334

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. ALLISON J MOOSALLY (MD)
NPI
1104847334
Phone
(216) 382-3806
Address
5915 Landerbrook Dr Ste 120
Enumeration Date
22 July 2006
Last Update Date
17 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3306650555
Graduation Year
2002 (24 years ago)
PAC ID
9830193648
Group Practice PAC ID
1456679646
Professional Enrollment ID
I20060911000302
Address ID
OH443334510FA3624XSTXX401

Contacts

Secure Messaging
am@alliedderm.emadirect.md
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness95
Years active:19State licenses:1Other names

607 DERMATOLOGY in OH

Provider Addresses for DR. ALLISON J MOOSALLY (MD)

  • 5915 Landerbrook Dr Ste 120

    Mayfield Hts, OH 441244034

    Phone: (216) 382-3806

    Type: Location

  • 3624, West Market Street, Fairlawn, Bath Township, Summit County, Ohio, 44333, United States

    SUITE 101

    FAIRLAWN, OH 443334510

    Phone: (330) 665-0555

    Fax: (330) 665-0556

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 82 Open Payments records for all available years, with a total value of $1,704.

Total Amount is formed as General ($1,704) + Research ($0) + Ownership ($0) = $1,704.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: ABBVIE INC. ($364).

Total Amount

$1,704

General + Research + Ownership

Payments

82

Total payment records

General Amount

$1,704

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2006-09-11

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060911000302IDermatologyOHTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17311Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks323257$0
17003Destruction of precancer skin growth, 2-14 growths18929$0
17312Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks151114$0
99212Established patient office or other outpatient visit, 10-19 minutes12892$0
13132Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm126113$0
View full utilization report →

Insurance plans in this area (ZIP 44124)

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Provider's Procedures

DR. ALLISON J MOOSALLY (MD) performs procedures in DERMATOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYOH17003Destruction of 2-14 skin growths21736

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1456679646View full group profile
NameSpecialtyState
Nurse PractitionerOH
D E R M A T O L O G YOH
D E R M A T O L O G YOH
D E R M A T O L O G YOH
D E R M A T O L O G YOH
D E R M A T O L O G YOH
Nurse PractitionerOH
-OH
D E R M A T O L O G YOH
D E R M A T O L O G YOH

Reviews

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Frequently asked questions

Can I verify DR. ALLISON J MOOSALLY (MD) with an NPI only?
You can start verification with NPI 1104847334 for DR. ALLISON J MOOSALLY (MD), then check state licensing separately.
Does CMS list DR. ALLISON J MOOSALLY (MD) as active?
Yes — DR. ALLISON J MOOSALLY (MD) is active in the NPI listing used on this page.
What taxonomy line describes DR. ALLISON J MOOSALLY (MD)?
For research purposes, treat DR. ALLISON J MOOSALLY (MD) as MOHS-Micrographic Surgery Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect DR. ALLISON J MOOSALLY (MD) on a map?
Expect Mayfield Hts, Ohio as a primary anchor for DR. ALLISON J MOOSALLY (MD) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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