SUPARNA MULLICK (MD) – Dermatology Physician, NPI 1366547713
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
293 DERMATOLOGY in TN
Provider Addresses for SUPARNA MULLICK (MD)
9760, Lipsey Cove, Germantown, Shelby County, Tennessee, 38139, United States
GERMANTOWN, TN 381398076
Phone: (901) 277-3534
Fax: (901) 757-9065
Type: Mailing
9760 Lipsey Cv
Germantown, TN 381398076
Phone: (901) 277-3534
Fax: (901) 757-9065
Type: Location
3036 CENTRE OAK WAY
GERMANTOWN, TN 381386302
Phone: (901) 572-0005
Fax: (901) 572-1102
Type: Location
PO BOX 758
PARIS, TN 382420758
Phone: (901) 572-0005
Fax: (901) 572-1102
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 83 Open Payments records for all available years, with a total value of $1,387.
Total Amount is formed as General ($1,387) + Research ($0) + Ownership ($0) = $1,387.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($271).
Total Amount
$1,387
General + Research + Ownership
Payments
83
Total payment records
General Amount
$1,387
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $271 |
| Dermavant Sciences, Inc. | $251 |
| Janssen Biotech, Inc. | $193 |
| PFIZER INC. | $191 |
| SUN PHARMACEUTICAL INDUSTRIES INC. | $95 |
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: 2013-07-25
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 |
|---|---|---|---|---|
| I20130725000846 | I | Dermatology | TN | 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 | 757 | 212 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 527 | 394 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 473 | 391 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 465 | 371 | $0 |
| 17004 | Destruction of precancer skin growth, 15 or more growths | 317 | 197 | $0 |
Insurance plans in this area (ZIP 38139)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA |
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