MARIO MITKOV (MD) – Dermatology Physician, NPI 1003226051
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
45 MICROGRAPHIC DERMATOLOGIC SURGERY (MDS) in VA
Provider Addresses for MARIO MITKOV (MD)
312 Fairy Street Ext Ste 201
Martinsville, VA 241121912
Phone: (276) 632-6496
Type: Location
1450 Professional Park Dr Ste 150
Winston Salem, NC 271031307
Phone: (336) 724-2434
Fax: (336) 607-8061
Type: Location
1450 PROFESSIONAL PARK DR STE 150
WINSTON SALEM, NC 271031307
Phone: (336) 724-2434
Fax: (336) 607-8061
Type: Mailing
3107 BRASSFIELD RD STE 300
GREENSBORO, NC 274102074
Phone: (336) 545-8133
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $129.
Total Amount is formed as General ($129) + Research ($0) + Ownership ($0) = $129.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: Kerecis Limited ($116).
Total Amount
$129
General + Research + Ownership
Payments
4
Total payment records
General Amount
$129
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Kerecis Limited | $116 |
| MIMEDX Group, Inc. | $13 |
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: 2019-08-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20150831002848 | I | Dermatology | FL | TBD |
| I20190814003016 | I | Dermatology | NC | TBD |
| I20190820000177 | I | Dermatology | VA | 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 |
|---|---|---|---|---|
| Q4190 | Artacent ac, per square centimeter | 836 | 17 | $0 |
| 17311 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | 468 | 326 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 222 | 168 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 217 | 130 | $0 |
| 17312 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks | 166 | 112 | $0 |
Insurance plans in this area (ZIP 24112)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | TX | |
| Physician Assistant | NC | |
| Physician Assistant | NC | |
| D E R M A T O L O G Y | NC | |
| Physician Assistant | NC | |
| Physician Assistant | NC | |
| Physician Assistant | NC | |
| Dermatology, Pathology | VA | |
| Internal Medicine, Dermatology | VA | |
| Physician Assistant | GA |
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