MR. HARUNA DIBBA (PA-C) – Surgical Physician Assistant, NPI 1710628631
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,678 PHYSICIAN ASSISTANT in WI
Provider Addresses for MR. HARUNA DIBBA (PA-C)
707 S UNIVERSITY AVE
BEAVER DAM, WI 539163027
Phone: (920) 356-6534
Type: Mailing
11911 NE 132ND ST STE 200
KIRKLAND, WA 980342900
Phone: (425) 899-5800
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $15.
Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.
Last reported payment date: 2023-10-04 • Largest payer in this snapshot: COLOPLAST CORP ($15).
Total Amount
$15
General + Research + Ownership
Payments
1
Total payment records
General Amount
$15
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| COLOPLAST CORP | $15 |
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: 2025-11-13
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 |
|---|---|---|---|---|
| I20220726001807 | I | Physician Assistant | WI | TBD |
| I20251113004067 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 65 | 44 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 55 | 38 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 21 | 21 | $0 |
Insurance plans in this area (ZIP 53916)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WA | |
| - | WA | |
| - | WA | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | WA | |
| Physician Assistant | WY | |
| - | WA | |
| Nurse Practitioner | WA | |
| Physician Assistant | WV | |
| Family Practice | VT | |
| - | WA |
Reviews
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