DAVID SURPRENANT – MOHS-Micrographic Surgery Physician, NPI 1265895932
MOHS-Micrographic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
607 DERMATOLOGY in OH
Provider Addresses for DAVID SURPRENANT
3025 Governors Place Blvd
Dayton, OH 454091330
Phone: (937) 293-5567
Type: Location
3025 GOVERNORS PLACE BLVD
DAYTON, OH 454091330
Phone: (937) 293-5567
Type: Mailing
120 SE 4TH ST
EVANSVILLE, IN 477081607
Phone: (812) 463-4306
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 132 Open Payments records for all available years, with a total value of $2,306.
Total Amount is formed as General ($2,306) + Research ($0) + Ownership ($0) = $2,306.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: ABBVIE INC. ($547).
Total Amount
$2,306
General + Research + Ownership
Payments
132
Total payment records
General Amount
$2,306
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $547 |
| Novartis Pharmaceuticals Corporation | $340 |
| GENZYME CORPORATION | $163 |
| Lilly USA, LLC | $161 |
| Amgen Inc. | $118 |
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: 2021-08-06
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 |
|---|---|---|---|---|
| I20210806000462 | I | Dermatology | IN | 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 |
|---|---|---|---|---|
| 17311 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | 633 | 488 | $0 |
| 17312 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks | 287 | 199 | $0 |
| 13132 | Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm | 198 | 180 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 123 | 89 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 100 | 85 | $0 |
Insurance plans in this area (ZIP 45409)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | IN | |
| Family Practice | MI | |
| Family Practice | IN | |
| - | IN | |
| Nurse Practitioner | IN | |
| - | TN | |
| Nurse Practitioner | IN | |
| - | KY | |
| Physician Assistant | OH | |
| Internal Medicine, Geriatric Medicine | IN |
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