DR. MISTY IRENE DICKERSON (D.O.) – Obstetrics & Gynecology Physician, NPI 1427296318
Obstetrics & Gynecology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,818 OBSTETRICS/GYNECOLOGY in OH
Provider Addresses for DR. MISTY IRENE DICKERSON (D.O.)
7740 WASHINGTON VILLAGE DRIVE
SUITE 100
CENTERVILLE, OH 454583994
Phone: (937) 531-7900
Fax: (937) 531-7901
Type: Location
Village Square Road, Centerville, Washington Township, Montgomery County, Ohio, 45458, United States
SUITE 100
CENTERVILLE, OH 454594056
Phone: (937) 531-7900
Fax: (937) 531-7901
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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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: 2012-10-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-10-31 (956 days ago).
Enrollment records
1
Earliest due date
2023-10-31
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 |
|---|---|---|---|---|
| I20121024000360 | I | Obstetrics/Gynecology | OH | 2023-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 |
|---|---|---|---|---|
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | 22 | 22 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 14 | 11 | $0 |
Insurance plans in this area (ZIP 45458)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Geriatric Medicine, Hematology/Oncology | IL | |
| Nurse Practitioner | OH | |
| Hematology/Oncology, Internal Medicine | OH | |
| Radiation Oncology | OH | |
| Nurse Practitioner | OH | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OH | |
| Orthopedic Surgery | OH | |
| Pulmonary Disease, Critical Care (Intensivists), Sleep Medicine | OH | |
| Physician Assistant | OH | |
| Hospitalist, Emergency Medicine | OH |
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