Active NPI 1457372724 Individual Practitioner Male Practitioner

Dr. Derek G Kenneaster , MD

Dermatology • Herrin, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Derek Kenneaster, MD is a certified Dermatology practicing in Herrin, IL. With approximately 33 years of clinical experience since graduating from Southern Illinois University School Of Medicine in 1993, Dr. Kenneaster delivers high-quality medical care to the local community at 220 N PARK AVE.

Dr. Kenneaster is affiliated with Southern Illinois Dermatology, Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

220 N Park Ave
Suite 2

Herrin, IL 629483150

Telephone 6189423344

Fax 6189425045

Associated Practice Facility / Clinic

🏢 Southern Illinois Dermatology, Pc Facility NPI 1306870233

Medicare Profile & Education

Medical School

Southern Illinois University School Of Medicine

Graduation Year

1993

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Herrin, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

33 Yrs -0.5 yrs vs City Avg

City Avg: 33.5 Yrs

State Avg: 23.1 Yrs

Regional Practice Density

2 Specialists

Practicing in Herrin, IL (673 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

50.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Kenneaster (33 Years) 33 Yrs

Herrin Specialty Average (33.5 Years) 33.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,482	304	$23.00	$6.07
99213 Established patient office or other outpatient visit, typically 15 minutes	918	479	$145.00	$86.66
17000 Destruction of skin growth	645	368	$135.00	$41.21
11103 Biopsy of related skin growth, each additional growth	554	273	$90.00	$46.65
11102 Tangential biopsy of single skin lesion	544	356	$170.00	$86.98
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	236	196	$90.00	$53.36
11104 Punch biopsy, first skin growth	208	174	$215.00	$114.47
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	143	87	$170.00	$55.18
17110 Destruction of up to 14 skin growths	117	98	$190.00	$95.21
17004 Destruction of precancer skin growth, 15 or more growths	115	79	$325.00	$155.84
11105 Punch biopsy, each additional skin growth	86	61	$105.00	$55.51
69100 Biopsy of ear	48	40	$180.00	$56.45
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	30	29	$505.00	$283.93
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	19	18	$415.00	$115.17
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	19	14	$500.00	$389.15
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	19	15	$205.00	$92.07
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	17	14	$200.00	$122.34
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	12	12	$285.00	$87.72

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,732	350	$23.00	$6.17
99213 Established patient office or other outpatient visit, typically 15 minutes	1,075	580	$145.00	$86.40
17000 Destruction of skin growth	756	432	$135.00	$44.31
11102 Tangential biopsy of single skin lesion	539	383	$170.00	$89.38
11103 Biopsy of related skin growth, each additional growth	339	210	$90.00	$47.54
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	216	181	$90.00	$53.79
11104 Punch biopsy, first skin growth	156	135	$215.00	$116.85
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	139	81	$170.00	$62.86
17110 Destruction of up to 14 skin growths	115	95	$190.00	$102.79
17004 Destruction of precancer skin growth, 15 or more growths	90	61	$325.00	$160.42
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	52	14	$10.00	$1.07
11105 Punch biopsy, each additional skin growth	48	42	$105.00	$56.24
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	38	27	$500.00	$385.09
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	36	33	$505.00	$280.60
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	36	36	$175.00	$108.62
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	34	27	$200.00	$128.16
69100 Biopsy of ear	32	29	$180.00	$64.56
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	27	22	$205.00	$98.45
11900 Injection into skin growth, 1-7 growths	26	14	$95.00	$46.00
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	25	24	$415.00	$121.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	12	11	$200.00	$123.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,998	310	$23.00	$6.36
99213 Established patient office or other outpatient visit, typically 15 minutes	829	530	$145.00	$87.94
17000 Destruction of skin growth	589	404	$135.00	$46.50
11102 Tangential biopsy of single skin lesion	423	344	$170.00	$87.59
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	253	218	$90.00	$54.69
11103 Biopsy of related skin growth, each additional growth	212	149	$90.00	$48.96
11104 Punch biopsy, first skin growth	130	122	$214.65	$118.91
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	112	85	$170.63	$77.12
17110 Destruction of up to 14 skin growths	108	94	$190.00	$102.67
17004 Destruction of precancer skin growth, 15 or more growths	81	58	$325.00	$161.42
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	62	21	$10.00	$1.15
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	59	59	$175.00	$107.65
11105 Punch biopsy, each additional skin growth	49	42	$105.00	$57.17
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	41	38	$505.00	$274.61
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	39	18	$500.00	$388.65
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	35	18	$200.00	$134.22
11900 Injection into skin growth, 1-7 growths	33	19	$95.00	$42.96
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	31	25	$204.03	$110.50
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	22	21	$415.00	$118.11
99202 New patient office or other outpatient visit, typically 20 minutes	19	19	$115.00	$70.64
69100 Biopsy of ear	17	16	$180.00	$66.01
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	13	$200.00	$124.06

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,845	291	$23.00	$6.21
99213 Established patient office or other outpatient visit, typically 15 minutes	835	542	$144.62	$89.74
17000 Destruction of skin growth	568	389	$135.00	$48.25
11102 Tangential biopsy of single skin lesion	387	322	$170.00	$90.24
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	298	240	$89.33	$54.83
11103 Biopsy of related skin growth, each additional growth	166	128	$90.00	$51.23
17110 Destruction of up to 14 skin growths	127	109	$190.00	$102.95
11104 Punch biopsy, first skin growth	113	110	$210.00	$124.08
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	109	83	$165.00	$65.67
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	86	22	$10.00	$1.27
17004 Destruction of precancer skin growth, 15 or more growths	71	54	$325.00	$160.85
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	66	66	$174.55	$110.61
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	46	34	$199.24	$127.52
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	45	40	$200.00	$107.21
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	39	35	$505.00	$289.06
11105 Punch biopsy, each additional skin growth	36	32	$105.00	$59.24
11900 Injection into skin growth, 1-7 growths	34	20	$95.00	$47.64
69100 Biopsy of ear	27	23	$180.00	$71.57
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	25	22	$415.00	$135.72
99202 New patient office or other outpatient visit, typically 20 minutes	22	22	$115.00	$71.59
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	14	11	$240.00	$128.39
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	12	12	$480.00	$138.18

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,553	282	$23.00	$5.74
99213 Established patient office or other outpatient visit, typically 15 minutes	582	447	$110.00	$73.42
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	565	386	$70.00	$44.26
17000 Destruction of skin growth	563	389	$135.00	$48.09
11102 Tangential biopsy of single skin lesion	290	240	$170.00	$89.51
11104 Punch biopsy, first skin growth	182	162	$210.00	$119.39
17110 Destruction of up to 14 skin growths	114	97	$190.00	$99.44
11103 Biopsy of related skin growth, each additional growth	105	82	$90.00	$51.63
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	101	29	$10.00	$1.46
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	52	44	$505.00	$292.49
99201 New patient office or other outpatient visit, typically 10 minutes	50	50	$68.00	$44.72
11105 Punch biopsy, each additional skin growth	49	41	$105.00	$58.80
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	46	35	$165.00	$71.44
11900 Injection into skin growth, 1-7 growths	37	24	$95.00	$47.25
17004 Destruction of precancer skin growth, 15 or more growths	37	31	$325.00	$153.48
69100 Biopsy of ear	33	28	$180.00	$81.28
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	29	24	$415.00	$121.27
99202 New patient office or other outpatient visit, typically 20 minutes	28	28	$115.00	$74.75
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	26	25	$200.00	$106.73
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	14	14	$480.00	$138.48
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	11	11	$280.00	$98.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,741	303	$23.00	$5.26
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	796	528	$70.00	$41.84
17000 Destruction of skin growth	606	414	$135.00	$47.81
99213 Established patient office or other outpatient visit, typically 15 minutes	554	417	$110.00	$69.33
11102 Tangential biopsy of single skin lesion	304	278	$170.00	$82.81
11104 Punch biopsy, first skin growth	226	212	$210.00	$112.21
17110 Destruction of up to 14 skin growths	146	122	$189.93	$94.37
11103 Biopsy of related skin growth, each additional growth	111	89	$90.00	$49.20
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	108	30	$10.00	$1.59
99201 New patient office or other outpatient visit, typically 10 minutes	82	82	$68.00	$43.05
11105 Punch biopsy, each additional skin growth	81	64	$105.00	$56.48
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	68	50	$165.00	$58.84
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	56	52	$505.00	$266.96
17004 Destruction of precancer skin growth, 15 or more growths	48	37	$325.00	$141.97
11900 Injection into skin growth, 1-7 growths	43	27	$95.00	$45.77
69100 Biopsy of ear	40	36	$180.00	$75.38
99202 New patient office or other outpatient visit, typically 20 minutes	33	33	$115.00	$72.14
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	32	29	$200.00	$95.95
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	26	25	$480.00	$130.13
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	22	18	$250.00	$99.90
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	18	17	$280.00	$78.88
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	18	17	$415.00	$116.23
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	16	15	$240.00	$118.33
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	12	12	$420.00	$229.19
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	12	11	$530.00	$274.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,605	311	$23.00	$5.10
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	844	569	$60.00	$41.94
17000 Destruction of skin growth	598	414	$135.00	$51.72
11100 Biopsy of single growth of skin and/or tissue	561	447	$175.00	$95.25
99213 Established patient office or other outpatient visit, typically 15 minutes	486	384	$100.00	$70.22
11101 Biopsy of each additional growth of skin and/or tissue	258	170	$62.75	$32.06
17110 Destruction of up to 14 skin growths	137	115	$189.93	$104.11
99201 New patient office or other outpatient visit, typically 10 minutes	115	115	$58.00	$42.81
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	114	25	$10.00	$1.83
99202 New patient office or other outpatient visit, typically 20 minutes	76	76	$100.00	$72.72
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	70	66	$505.00	$282.83
17004 Destruction of precancer skin growth, 15 or more growths	51	38	$325.00	$139.90
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	33	29	$415.00	$120.28
11900 Injection into skin growth, 1-7 growths	31	18	$95.00	$47.38
69100 Biopsy of ear	25	24	$180.00	$73.68
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	21	21	$479.76	$142.86
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	20	18	$250.00	$104.88
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	18	11	$40.00	$19.52
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	17	15	$280.00	$90.97
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	16	15	$463.00	$140.21
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	15	14	$510.00	$276.14
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	14	13	$530.00	$206.16
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	14	13	$485.00	$250.40

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,673	315	$23.00	$5.40
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	736	499	$60.03	$41.61
17000 Destruction of skin growth	603	421	$135.00	$50.44
99213 Established patient office or other outpatient visit, typically 15 minutes	569	441	$100.00	$69.97
11100 Biopsy of single growth of skin and/or tissue	544	456	$175.00	$92.04
11101 Biopsy of each additional growth of skin and/or tissue	244	173	$62.75	$31.75
17110 Destruction of up to 14 skin growths	133	120	$190.00	$102.64
99201 New patient office or other outpatient visit, typically 10 minutes	116	116	$58.00	$42.22
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	96	22	$10.00	$1.79
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	78	68	$505.00	$284.29
99202 New patient office or other outpatient visit, typically 20 minutes	73	73	$100.00	$71.99
17004 Destruction of precancer skin growth, 15 or more growths	43	34	$325.00	$143.95
69100 Biopsy of ear	36	30	$180.00	$73.95
11900 Injection into skin growth, 1-7 growths	35	21	$95.00	$49.57
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	33	28	$415.00	$117.02
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	26	25	$475.00	$142.28
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	25	23	$250.00	$105.70
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	24	23	$280.00	$96.21
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	17	16	$510.00	$263.95
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	13	12	$463.00	$140.93
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	12	12	$485.00	$243.48

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License FL ME94334

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

036093018 (IL)

Commercial Insurance / Payer ID Bcbs

10007459

Commercial Insurance / Payer ID Medicare Ptan

65958

Commercial Insurance / Payer ID Bcbs

31057 (FL)

Hospital & Practice Group Affiliations

Southern Illinois Dermatology, Pc

108 N Emma St, West Frankfort, IL 628962443

Phone: 6189371346

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners

Leon Gauthier , PA-C

Physician Assistant

NPI 1033145172

Physician Assistant (Certified)

Joshua Loyd , FNP-BC

Nurse Practitioner - Family

NPI 1598445405

Family Nurse Practitioner (Board Certified)

Dr. Ted Van Acker , DO

Dermatology

NPI 1720025562

Doctor of Osteopathic Medicine (D.O.)

Shanda Swagler , FNP-C

Nurse Practitioner - Family

NPI 1750526810

Family Nurse Practitioner (Certified)

Natalie Spiller , PA-C

Physician Assistant

NPI 1942550272

Physician Assistant (Certified)

Gerri Dyer , NP

Nurse Practitioner

NPI 1952328486

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active March 23, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location March 23, 2011

Registered at 220 N PARK AVE, SUITE 2, HERRIN, IL 629483150 (Tel: 6189423344)

📍

Updated Business Mailing Address March 23, 2011

Registered at 220 N PARK AVE, SUITE 2, HERRIN, IL 629483150 (Tel: 6189423344)

👤

Provider Name / Credentials Updated March 23, 2011

Recorded as DEREK KENNEASTER, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 23, 2011

Dermatology (License #ME94334 in FL)

🟢

Initial NPI Registration & Enumeration July 22, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1457372724

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 22, 2006

Last Update: March 23, 2011

Sole Proprietor: No

Update or Correct Profile

Mailing Address

220 N Park Ave, Suite 2

Herrin, IL 629483150

Phone: 6189423344

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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