SCOTT C WICKLESS (DO) – Dermatology Physician, NPI 1043222714
Dermatology Physician
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Profile Insights
NPPES metrics only — not quality of care.
1,284 DERMATOLOGY in TX
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Provider Addresses for SCOTT C WICKLESS (DO)
6655, North MacArthur Boulevard, Las Colinas, Irving, Dallas County, Texas, 75039, United States
IRVING, TX 750392443
Phone: (214) 277-8700
Fax: (214) 596-7484
Type: Location
4919 MEMORIAL HWY STE 150
TAMPA, FL 336347516
Phone: (813) 333-1528
Fax: (813) 255-2818
Type: Mailing
1801 S OSPREY AVE UNIT 201
SARASOTA, FL 342393625
Phone: (941) 957-4767
Fax: (941) 955-7334
Type: Location
1849 S OSPREY AVE
SARASOTA, FL 342393614
Phone: (941) 957-4767
Fax: (941) 955-7334
Type: Location
Dallas VA Medical Center, 4500, South Lancaster Road, Dallas, TX, Dallas, Dallas County, Texas, 75216, United States
3RD FLOOR DERMATOLOGY CLINIC
DALLAS, TX 752167167
Phone: (214) 742-8387
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2023-09-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20090915000442 | I | Dermatology | CO | TBD |
| I20230926002144 | I | Dermatology | NM | 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 |
|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 1,684 | 1,151 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 908 | 205 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 471 | 390 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 324 | 285 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 191 | 167 | $0 |
Insurance plans in this area (ZIP 75039)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | TX | |
| D E R M A T O L O G Y | TX | |
| D E R M A T O L O G Y | TX | |
| Nurse Practitioner | CO | |
| D E R M A T O L O G Y | CO | |
| D E R M A T O L O G Y | CO | |
| D E R M A T O L O G Y | CO | |
| Nurse Practitioner | CO | |
| D E R M A T O L O G Y | CO | |
| D E R M A T O L O G Y | FL |
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