MARCOS ANTEZANA (M.D.) – Dermatology Physician, NPI 1104892843
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
393 DERMATOLOGY in WA
Provider Addresses for MARCOS ANTEZANA (M.D.)
1145 Broadway
Seattle, WA 981224201
Phone: (206) 860-5393
Type: Location
Kelley Ross Pharmacy, 904, 7th Avenue, Central Business District, First Hill, Seattle, King County, Washington, 98138, United States
SEATTLE, WA 981041132
Phone: (206) 860-2387
Fax: (206) 860-2219
Type: Location
PO BOX 5127
EVERETT, WA 982065127
Phone: (206) 860-5414
Fax: (206) 720-8462
Type: Mailing
7600 EVERGREEN WAY
EVERETT, WA 982036421
Phone: (206) 860-5414
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: 2004-05-07
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 |
|---|---|---|---|---|
| I20040507000132 | I | Dermatology | WA | 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 | 1,836 | 290 | $0 |
| 95044 | Test for allergy using skin patch | 1,513 | 21 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 851 | 578 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 483 | 351 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 294 | 226 | $0 |
Insurance plans in this area (ZIP 98122)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | WA | 17003 | Destruction of 2-14 skin growths | 1418 | 250 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine | WA | |
| Nurse Practitioner | CA | |
| R H E U M A T O L O G Y | WA | |
| - | WA | |
| - | WA | |
| Internal Medicine | UT | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | WA | |
| Clinical Social Worker | WA | |
| N E P H R O L O G Y | WA | |
| - | WA |
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