Doctor profile · Federal record
Dr. Dallas Provence, NP
Dermatopathology Physician (CMS: Nurse Practitioner) · Memphis, TN
- NPI 1619556230
- Accepts Medicare
- 6 yrs in practice
- Female
- Solo practice
- No sanctions
Practice & contact
- Primary practice
-
6254 Poplar Ave
Memphis, TN 381194713
(901) 624-3333 - Mailing address
-
295 Pandora St
Memphis, TN 381172854
Credentials & registration
- NPI registered
- April 2021 — 5 yrs on file
- Year of graduation
- 2020 — 6 yrs since
- Specialty taxonomy
- 207ND0900X — NUCC code
- State license (1)
- Tennessee #28973
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1619556230. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
2,239
Distinct HCPCS
10
Medicare allowed
$105,668
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
17003 |
Destruction of precancer skin growth, 2-14 growths | 734 | 147 | $5 | |
99213 |
Established patient office or other outpatient visit, 20-29 minutes | 332 | 275 | $70 | |
11102 |
Biopsy of related skin growth, first growth | 264 | 234 | $70 | |
17000 |
Destruction of precancer skin growth, 1 growth | 256 | 208 | $37 | |
17110 |
Destruction of skin growth, 1-14 growths | 150 | 124 | $87 | |
11103 |
Biopsy of related skin growth, each additional growth | 131 | 79 | $39 | |
99214 |
Established patient office or other outpatient visit, 30-39 minutes | 120 | 102 | $100 | |
99203 |
New patient office or other outpatient visit, 30-44 minutes | 93 | 93 | $88 | |
99212 |
Established patient office or other outpatient visit, 10-19 minutes | 80 | 75 | $44 | |
99204 |
New patient office or other outpatient visit, 45-59 minutes | 28 | 28 | $131 |
In context: peer comparison
Among 4 peers in Memphis Dermatopathology Physician, average services per provider: 233. This provider delivers 9.6× the peer median.Open Payments
Industry payments received
All-time total
$1,786
Transactions
77
Manufacturers
15
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Abbvie INC. | 23 | $245.23 | |
| Dermavant Sciences, INC. | 9 | $219.03 | |
| Genzyme Corporation | 7 | $172.42 | |
| Sun Pharmaceutical Industries INC. | 6 | $170.73 | |
| Regeneron Healthcare Solutions, INC. | 2 | $143.46 | |
| Ortho Dermatologics, A Division of Bausch Health US, LLC | 1 | $118.85 | |
| Lilly USA, LLC | 6 | $106.22 | |
| Sanofi-Aventis U.S. LLC | 1 | $99.00 | |
| Amgen INC. | 4 | $96.35 | |
| Leo Pharma INC. | 4 | $88.99 | |
| Ucb, INC. | 4 | $88.26 | |
| Galderma Laboratories, L.P. | 3 | $55.11 | |
| Novartis Pharmaceuticals Corporation | 3 | $48.48 | |
| E.R. Squibb & Sons, L.L.C. | 2 | $44.09 | |
| Incyte Corporation | 2 | $41.64 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
229
Patients
174
Total drug cost
$5,579
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Ketoconazole | Generic | 46 | 31 | $730 |
| Mupirocin | Generic | 35 | 29 | $274 |
| Triamcinolone Acetonide | Generic | 31 | 23 | $360 |
| Mometasone Furoate | Generic | 29 | 20 | $798 |
| Doxycycline Hyclate | Generic | 27 | 24 | $303 |
| Fluocinonide | Generic | 22 | 15 | $1,129 |
| Clobetasol Propionate | Generic | 20 | 15 | $1,878 |
| Hydrocortisone | Generic | 19 | 17 | $108 |
Frequently asked questions
What is Dr. Dallas Provence's medical specialty?
Dr. Dallas Provence practices Dermatopathology Physician in Memphis, TN.
Where does Dr. Dallas Provence practice?
Dr. Dallas Provence practices at 6254 Poplar Ave, Memphis, TN 381194713. Office phone: 9016243333.
What is Dr. Dallas Provence's NPI?
Dr. Dallas Provence's National Provider Identifier (NPI) is 1619556230, issued by NPPES.
Does Dr. Dallas Provence accept Medicare assignment?
Yes. Dr. Dallas Provence accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Dallas Provence commonly perform?
Top Medicare-reported procedures in 2023: Destruction of precancer skin growth, 2-14 growths (HCPCS 17003); Established patient office or other outpatient visit (HCPCS 99213); Biopsy of related skin growth, first growth (HCPCS 11102). Source: CMS Medicare Physician & Other Practitioners file.