Deactivated NPI 1184690406 Deactivated / Inactive NPI Male Practitioner

John Frederick Chambliss , MS PAC

Physician Assistant • East Windsor, NJ

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, John Chambliss has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 27, 2006

NPI Deactivation Date July 07, 2022

Total Practice Duration ~16 Years of Practice (2006 – 2022)

Professional Overview & Biography Verified Profile Summary

John Chambliss, MS PAC was a registered Physician Assistant practicing in East Windsor, NJ. Throughout an active medical career spanning 16 years, John Chambliss provided care at the practice location at 59 ONE MILE RD until profile deactivation on 2022-07-07.

Historical Medicare Part B clinical services included destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

59 One Mile Rd
Ste G

East Windsor, NJ 08520

Telephone 6094434500

Fax 6094434808

Associated Practice Facility / Clinic

🏢 Windsor Dermatology Pc Facility NPI 1053429720

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in East Windsor, NJ

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 6.7 Yrs

State Avg: 10.1 Yrs

Regional Practice Density

10 Specialists

Practicing in East Windsor, NJ (3413 Statewide)

Telehealth Adoption Rate

10.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

7.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2022)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	148	29	$5.48	$5.30
99213 Established patient office or other outpatient visit, typically 15 minutes	70	67	$75.72	$73.27
17000 Destruction of skin growth	43	39	$55.01	$41.66
11102 Tangential biopsy of single skin lesion	39	37	$83.81	$76.81
11103 Biopsy of related skin growth, each additional growth	18	12	$42.14	$40.54
99202 New patient office or other outpatient visit, typically 20 minutes	13	13	$61.46	$58.46
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	11	11	$107.28	$103.39

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	963	192	$28.00	$5.81
99213 Established patient office or other outpatient visit, typically 15 minutes	426	406	$246.00	$79.76
17000 Destruction of skin growth	285	268	$229.00	$47.56
17110 Destruction of up to 14 skin growths	158	121	$393.00	$100.56
11102 Tangential biopsy of single skin lesion	144	133	$346.00	$84.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	110	106	$362.00	$113.09
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	48	45	$150.00	$49.22
11103 Biopsy of related skin growth, each additional growth	46	33	$186.00	$47.15
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	28	28	$364.00	$98.02
17004 Destruction of precancer skin growth, 15 or more growths	23	22	$499.00	$147.31
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	19	19	$551.00	$146.17
11601 Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs	16	16	$795.00	$199.97
99202 New patient office or other outpatient visit, typically 20 minutes	13	13	$254.00	$63.89

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	562	133	$28.00	$5.19
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	389	387	$362.00	$92.24
17000 Destruction of skin growth	212	202	$229.00	$45.74
99213 Established patient office or other outpatient visit, typically 15 minutes	174	170	$246.00	$64.47
17110 Destruction of up to 14 skin growths	141	129	$393.00	$96.20
11102 Tangential biopsy of single skin lesion	113	108	$346.00	$76.61
17004 Destruction of precancer skin growth, 15 or more growths	39	38	$499.00	$135.98
11103 Biopsy of related skin growth, each additional growth	27	22	$186.00	$45.71
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$364.00	$91.86
99202 New patient office or other outpatient visit, typically 20 minutes	20	20	$254.00	$65.02
99201 New patient office or other outpatient visit, typically 10 minutes	12	12	$165.00	$39.62
69100 Biopsy of ear	11	11	$351.00	$80.98

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,449	288	$28.00	$5.00
99213 Established patient office or other outpatient visit, typically 15 minutes	937	811	$246.00	$64.73
17000 Destruction of skin growth	467	397	$229.00	$47.13
17110 Destruction of up to 14 skin growths	307	225	$393.00	$96.45
11102 Tangential biopsy of single skin lesion	224	213	$341.69	$78.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	102	102	$364.00	$94.51
99202 New patient office or other outpatient visit, typically 20 minutes	81	81	$254.00	$66.74
11103 Biopsy of related skin growth, each additional growth	60	40	$178.00	$47.08
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	54	12	$15.00	$1.60
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	49	32	$1214.00	$390.08
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	48	39	$362.00	$94.81
17004 Destruction of precancer skin growth, 15 or more growths	42	42	$499.00	$134.44
96573 Application of light by qualified health care professional to destroy precancer skin growth	36	32	$676.00	$179.24
99201 New patient office or other outpatient visit, typically 10 minutes	33	33	$165.00	$40.10
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	27	22	$420.00	$96.46
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	20	20	$150.00	$39.45
11601 Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs	20	18	$795.00	$182.47
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	18	16	$608.00	$147.31
69100 Biopsy of ear	17	17	$351.00	$74.32
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	15	14	$521.00	$120.68
11104 Punch biopsy, first skin growth	12	11	$425.00	$109.97
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	11	11	$1052.00	$257.20

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,518	304	$28.00	$4.67
99213 Established patient office or other outpatient visit, typically 15 minutes	828	747	$245.86	$63.69
17000 Destruction of skin growth	499	437	$226.56	$48.03
17110 Destruction of up to 14 skin growths	284	232	$380.58	$98.21
11100 Biopsy of single growth of skin and/or tissue	226	222	$357.77	$86.27
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	162	162	$348.20	$94.41
99202 New patient office or other outpatient visit, typically 20 minutes	102	102	$253.18	$65.68
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	75	60	$347.08	$93.98
17004 Destruction of precancer skin growth, 15 or more growths	49	48	$492.57	$127.87
11101 Biopsy of each additional growth of skin and/or tissue	49	38	$107.41	$28.72
99201 New patient office or other outpatient visit, typically 10 minutes	42	42	$165.00	$39.13
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	35	34	$147.26	$38.44
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	33	26	$413.18	$95.46
69100 Biopsy of ear	22	21	$333.73	$73.16
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	19	18	$496.37	$129.27
11601 Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs	12	11	$750.75	$143.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,555	285	$28.00	$4.96
99213 Established patient office or other outpatient visit, typically 15 minutes	784	688	$245.01	$63.53
17000 Destruction of skin growth	473	408	$210.00	$48.59
11100 Biopsy of single growth of skin and/or tissue	254	241	$300.00	$82.66
17110 Destruction of up to 14 skin growths	252	206	$330.00	$96.53
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	180	180	$300.00	$93.93
99202 New patient office or other outpatient visit, typically 20 minutes	129	129	$250.39	$65.22
11101 Biopsy of each additional growth of skin and/or tissue	73	50	$95.00	$28.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	63	57	$286.00	$93.38
17004 Destruction of precancer skin growth, 15 or more growths	49	46	$435.51	$132.26
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	45	45	$116.96	$38.07
99201 New patient office or other outpatient visit, typically 10 minutes	34	34	$165.00	$38.34
69100 Biopsy of ear	30	28	$275.00	$72.72
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	28	26	$329.89	$102.77
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	21	20	$471.81	$138.96
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	19	12	$600.00	$355.56
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	19	12	$475.00	$120.80
11601 Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs	18	16	$616.22	$162.32
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	17	15	$825.00	$267.10
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	14	14	$703.00	$132.51

Medical Specialties & State Licenses

CMS Verified: 2022-10-12

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License NJ 25MP00040300

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License GA 10785

Physician Assistant - Surgical

NUCC Taxonomy Code: 363AS0400X

State License GA 10785

Definition to come...

Practice Associates & Co-Workers

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

8 Associated Practitioners

Harika Vemulapalli , PA-C

Physician Assistant

NPI 1063197390

Physician Assistant (Certified)

Nidhi Avichal

Nurse Practitioner - Family

NPI 1114746195

Dr. Judit Stenn , MD

Dermatology

NPI 1407823669

Doctor of Medicine (M.D.)

Dr. Wendy Myers , MD

Dermatology

NPI 1497876601

Doctor of Medicine (M.D.)

Dr. Jessica Simon , MD

Specialist

NPI 1659651099

Doctor of Medicine (M.D.)

Alexa Hetzel , PA-C

Physician Assistant

NPI 1851887301

Physician Assistant (Certified)

Career & Practice History Timeline

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

13 Historical Events

📍

Updated Practice Location October 12, 2022

Registered at 59 ONE MILE RD, STE G, EAST WINDSOR, NJ 08520 (Tel: 6094434500)

📍

Updated Business Mailing Address October 12, 2022

Registered at 2400 BELLEVUE RD, STE 21A, DUBLIN, GA 310212890 (Tel: 4783280281)

👤

Provider Name / Credentials Updated October 12, 2022

Recorded as JOHN CHAMBLISS, MS PAC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 12, 2022

Physician Assistant (License #10785 in GA)

⚠️

NPI Profile Deactivated July 07, 2022

Record deactivated on July 07, 2022

📍

Updated Business Mailing Address December 07, 2021

Registered at 2400 BELLEVUE RD, STE 21A, DUBLIN, GA 310212890 (Tel: 4783280281)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 07, 2021

Physician Assistant (License #10785 in GA)

✅

NPI Profile Active November 10, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location November 10, 2015

Registered at 59 ONE MILE RD, STE G, EAST WINDSOR, NJ 08520 (Tel: 6094434500)

📍

Updated Business Mailing Address November 10, 2015

Registered at 526 MAIN ST 302, ACTON, MA 017203301 (Tel: 9788497507)

👤

Provider Name / Credentials Updated November 10, 2015

Recorded as JOHN CHAMBLISS, MS PAC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 10, 2015

Physician Assistant (License #25MP00040300 in NJ)

🟢

Initial NPI Registration & Enumeration February 27, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1184690406

Entity Type:

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

Enumeration Date: February 27, 2006

Last Update: July 13, 2026

Deactivation Date: July 07, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2400 Bellevue Rd, Ste 21a

Dublin, GA 310212890

Phone: 4783280281

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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