REGENTS OF THE UNIVERSITY OF MICHIGAN – Dermatology Physician, NPI 1528097128
Dermatology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for REGENTS OF THE UNIVERSITY OF MICHIGAN
Mott Children's Hospital and Von Voigtlander Women's Hospital, 1500, East Medical Center Drive, Ann Arbor, Washtenaw County, Michigan, 48109, United States
1ST FLOOR TAUBMAN CENTER RECP B
ANN ARBOR, MI 481090314
Phone: (734) 936-4054
Type: Location
South State Street, Ann Arbor, Washtenaw County, Michigan, 48108-1774, United States
PROVIDER ENROLLMENT
ANN ARBOR, MI 481081633
Phone: (734) 647-5299
Type: Mailing
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 481095000
Phone: (734) 936-4000
Type: Location
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: 2003-11-17
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 |
|---|---|---|---|---|
| O20031117000318 | O | Clinic/Group Practice | MI | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48109)
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