KYLE L WAGAMON (MD) – Dermatopathology Physician, NPI 1780758003
Dermatopathology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
607 DERMATOLOGY in OH
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Provider Addresses for KYLE L WAGAMON (MD)
2660, East Market Street, Warren, Trumbull County, Ohio, 44483, United States
WARREN, OH 444836204
Phone: (330) 393-4000
Fax: (330) 392-5870
Type: Location
2660 E Market St
Warren, OH 444836204
Phone: (330) 393-4000
Fax: (330) 392-5870
Type: Location
1745 NILES CORTLAND RD NE STE 5
WARREN, OH 444846046
Phone: (330) 856-6365
Fax: (330) 474-3981
Type: Location
19301, Cyclone Drive, Hopkins, Riverside, Cleveland, Cuyahoga County, Ohio, 44135, United States
CLEVELAND, OH 441351731
Phone: (330) 393-4000
Fax: (330) 392-5870
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $251.
Total Amount is formed as General ($251) + Research ($0) + Ownership ($0) = $251.
Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Arcutis Biotherapeutics, Inc. ($60).
Total Amount
$251
General + Research + Ownership
Payments
13
Total payment records
General Amount
$251
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-20
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: 2007-07-11
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 |
|---|---|---|---|---|
| I20070711000043 | I | Dermatology | OH | 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 | 6,797 | 1,020 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 1,820 | 1,286 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1,690 | 1,246 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 710 | 590 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 581 | 474 | $0 |
Insurance plans in this area (ZIP 44483)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | OH | 17003 | Destruction of 2-14 skin growths | 5822 | 1021 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OH | |
| D E R M A T O L O G Y | OH | |
| Nurse Practitioner | OH | |
| - | OH | |
| D E R M A T O L O G Y | OH |
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