MALLORY DES CHAMPS – Medical Physician Assistant, NPI 1740848985
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,243 PHYSICIAN ASSISTANT in NY
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Provider Addresses for MALLORY DES CHAMPS
Bryant University, 1150, Douglas Pike, Smithfield, Providence County, Rhode Island, 02917, United States
SMITHFIELD, RI 029171291
Phone:
Type: Mailing
4th Avenue, Fort Greene, Brooklyn, Kings County, New York, 11227, United States
BROOKLYN, NY 112093957
Phone: (718) 491-5800
Fax: (718) 748-2151
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 233 Open Payments records for all available years, with a total value of $4,327.
Total Amount is formed as General ($4,327) + Research ($0) + Ownership ($0) = $4,327.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Dermavant Sciences, Inc. ($934).
Total Amount
$4,327
General + Research + Ownership
Payments
233
Total payment records
General Amount
$4,327
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
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: 2020-01-22
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 |
|---|---|---|---|---|
| I20200122000287 | I | Physician Assistant | NY | 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 | 16 | 14 | $0 |
Insurance plans in this area (ZIP 02917)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | NY | |
| Physician Assistant | NY | |
| Micrographic Dermatologic Surgery (Mds), Dermatology | NY | |
| D E R M A T O L O G Y | NY | |
| D E R M A T O L O G Y | NY | |
| Physician Assistant | NY | |
| D E R M A T O L O G Y | NY | |
| Physician Assistant | MA | |
| Nurse Practitioner | NY | |
| - | NY |
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