Unknown Individual – Dermatology Physician, NPI 1962476978
Dermatology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
801, York Street, Manitowoc, Manitowoc County, Wisconsin, 54220, United States
MANITOWOC, WI 542204630
Phone:
Type: Mailing
Homewood Suites Birmingham-South/Inverness, 215, Inverness Center Drive, Morning Sun Villas, Birmingham, Shelby County, Alabama, 35242, United States
BIRMINGHAM, AL 352424834
Phone: (205) 995-5575
Fax: (205) 995-5576
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 45 Open Payments records for all available years, with a total value of $994.
Total Amount is formed as General ($994) + Research ($0) + Ownership ($0) = $994.
Last reported payment date: 2023-10-13 • Largest payer in this snapshot: Dermavant Sciences, Inc. ($193).
Total Amount
$994
General + Research + Ownership
Payments
45
Total payment records
General Amount
$994
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dermavant Sciences, Inc. | $193 |
| ABBVIE INC. | $161 |
| Regeneron Healthcare Solutions, Inc. | $112 |
| Lilly USA, LLC | $109 |
| LEO Pharma Inc. | $81 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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 | 165 | 40 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 108 | 95 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 81 | 73 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 69 | 65 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 64 | 55 | $0 |
Insurance plans in this area (ZIP 54220)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| Physician Assistant | VA | |
| - | VA | |
| D E R M A T O L O G Y | TX | |
| - | WI | |
| D E R M A T O L O G Y | AL | |
| D E R M A T O L O G Y | WI | |
| - | WI | |
| Physician Assistant | NY | |
| D E R M A T O L O G Y | WA |
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