DR. STEPHEN JOHN MANNINO (M.D.) – Dermatology Physician, NPI 1679553218
Dermatology Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
232 DERMATOLOGY in OR
Loading map...
Provider Addresses for DR. STEPHEN JOHN MANNINO (M.D.)
The Portland Clinic, 800, Southwest 13th Avenue, Portland Downtown, Portland, Metro, Multnomah County, Oregon, 97205, United States
PORTLAND, OR 972051902
Phone: (503) 221-0161
Fax: (503) 274-1697
Type: Mailing
4004 Kruse Way Pl Ste 220
Lake Oswego, OR 970352449
Phone: (503) 245-2415
Fax: (503) 244-5963
Type: Location
10215 SW HALL BLVD
TIGARD, OR 972238809
Phone: (503) 245-2415
Fax: (503) 244-5963
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $15.
Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.
Last reported payment date: 2023-04-24 • Largest payer in this snapshot: PFIZER INC. ($15).
Total Amount
$15
General + Research + Ownership
Payments
1
Total payment records
General Amount
$15
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $15 |
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: 2012-08-15
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 |
|---|---|---|---|---|
| I20120815000192 | I | Dermatology | OR | 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 | 244 | 77 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 224 | 177 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 143 | 114 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 57 | 53 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 39 | 39 | $0 |
Insurance plans in this area (ZIP 97205)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | OR | 17003 | Destruction of 2-14 skin growths | 361 | 55 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | OR | |
| Physician Assistant | NV | |
| Physician Assistant | ID | |
| D E R M A T O L O G Y | NV | |
| - | AK | |
| - | ID | |
| D E R M A T O L O G Y | OH | |
| Physician Assistant | TX | |
| Physician Assistant | OR | |
| Physician Assistant | OR |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.