DIANE M THIBOUTOT (MD) – Dermatology Physician, NPI 1104889831
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
808 DERMATOLOGY in PA
Provider Addresses for DIANE M THIBOUTOT (MD)
PO BOX 858
MC A410
HERSHEY, PA 170330858
Phone: (800) 243-1455
Type: Mailing
201 Lefever Rd
Mount Joy, PA 175528803
Phone: (717) 653-2900
Fax: (717) 653-2910
Type: Location
121 N Nyes Rd Ste C
Harrisburg, PA 171123248
Phone: (717) 657-4040
Fax: (717) 671-9038
Type: Location
Hershey Medical Center, 500, University Drive, Hershey, Dauphin County, Pennsylvania, 17033, United States
HERSHEY, PA 170332360
Phone: (717) 531-6820
Fax: (717) 531-4702
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $210.
Total Amount is formed as General ($210) + Research ($0) + Ownership ($0) = $210.
Last reported payment date: 2023-03-18 • Largest payer in this snapshot: Regeneron Pharmaceuticals, Inc. ($195).
Total Amount
$210
General + Research + Ownership
Payments
3
Total payment records
General Amount
$210
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Regeneron Pharmaceuticals, Inc. | $195 |
| 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: 2005-04-22
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 |
|---|---|---|---|---|
| I20050422001153 | I | Dermatology | PA | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 248 | 214 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 184 | 63 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 111 | 89 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 83 | 76 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 81 | 70 | $0 |
Insurance plans in this area (ZIP 17033)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | PA | 17003 | Destruction of 2-14 skin growths | 90 | 24 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| P A T H O L O G Y | PA | |
| Vascular Surgery | MD | |
| O P H T H A L M O L O G Y | PA | |
| - | PA | |
| Nurse Practitioner | PA | |
| - | FL | |
| - | PA | |
| - | PA | |
| Emergency Medicine | PA | |
| Critical Care (Intensivists) | PA |
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