MARK L DONALDSON (MD) – Dermatology Physician, NPI 1982662102
Dermatology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
197 DERMATOLOGY in UT
Provider Addresses for MARK L DONALDSON (MD)
2976 CHEROKEE LN
PROVO, UT 846044356
Phone: (801) 687-7575
Type: Mailing
2976 CHEROKEE LN STE 111
PROVO, UT 846044356
Phone: (801) 687-7575
Type: Location
Revere Health, 1055, North 500 West, North Park, Provo, Utah County, Utah, 84604, United States
CREDENTIALING DEPARTMENT
PROVO, UT 846043305
Phone: (801) 354-8225
Fax: (801) 418-0941
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 60 Open Payments records for all available years, with a total value of $2,945.
Total Amount is formed as General ($2,945) + Research ($0) + Ownership ($0) = $2,945.
Last reported payment date: 2024-12-02 • Largest payer in this snapshot: Premier Dental Products Company ($1,750).
Total Amount
$2,945
General + Research + Ownership
Payments
60
Total payment records
General Amount
$2,945
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Premier Dental Products Company | $1,750 |
| ABBVIE INC. | $304 |
| Novartis Pharmaceuticals Corporation | $204 |
| Janssen Biotech, Inc. | $138 |
| PFIZER INC. | $79 |
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: 2005-03-23
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 |
|---|---|---|---|---|
| I20050323001424 | I | Dermatology | UT | 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 | 1,762 | 306 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 633 | 452 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 547 | 390 | $0 |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 158 | 107 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 88 | 79 | $0 |
Insurance plans in this area (ZIP 84604)
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Provider's Procedures
Group practice members
- 1
- 2
- 3
- 4
- 5
| Name | Specialty | State |
|---|---|---|
| - | UT | |
| - | UT | |
| Physical Therapist In Private Practice | UT | |
| Orthopedic Surgery | UT | |
| Nurse Practitioner | OR | |
| - | FL | |
| - | UT | |
| - | UT | |
| Nurse Practitioner | UT | |
| - | UT |
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