Active NPI 1790787067 Individual Practitioner Male Practitioner

Dr. Michael J. Wells , MD

Dermatology - MOHS-Micrographic Surgery • Plano, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Michael Wells, MD is a certified Dermatology - MOHS-Micrographic Surgery practicing in Plano, TX. With approximately 29 years of clinical experience since graduating from University Of Arkansas College Of Medicine in 1997, Dr. Wells delivers high-quality medical care to the local community at 6100 WINDHAVEN PKWY.

Dr. Wells accepts Medicare assignment.

Frequently performed procedures and clinical services include complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm, new patient outpatient office visit, repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

6100 Windhaven Pkwy

Plano, TX 75093

Telephone 9723780620

Fax 9723780630

Associated Practice Facility / Clinic

🏢 Karen A. Lund, M.d. Pa Facility NPI 1720263544

Medicare Profile & Education

Medical School

University Of Arkansas College Of Medicine

Graduation Year

1997

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology - MOHS-Micrographic Surgery in Plano, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

29 Yrs +4.8 yrs vs City Avg

City Avg: 24.2 Yrs

State Avg: 20.1 Yrs

Regional Practice Density

9 Specialists

Practicing in Plano, TX (123 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

59.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wells (29 Years) 29 Yrs

Plano Specialty Average (24.2 Years) 24.2 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
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	261	229	$1500.00	$471.26
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	254	254	$220.00	$168.67
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	154	138	$1100.00	$424.28
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	122	117	$150.00	$128.68
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	96	92	$1600.00	$1094.47
14302 Repair of wound by transferring skin, each additional 30.0 sq cm	91	55	$500.00	$216.94
13133 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less	86	71	$1200.00	$169.94
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	80	70	$600.00	$126.00
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	62	60	$1600.00	$493.71
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	57	54	$1000.00	$393.38
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	48	45	$975.00	$673.70
13102 Complicated repair of wound of trunk, each additional 5.0 cm or less	35	30	$600.00	$116.89
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	32	32	$3000.00	$1006.66
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	27	21	$550.00	$412.35
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	20	19	$2550.00	$1009.27
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	17	15	$975.00	$624.33
11102 Tangential biopsy of single skin lesion	13	12	$300.00	$89.17
11403 Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm	12	11	$550.00	$99.67

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q4121 Theraskin, per square centimeter	2,848	19	$45.00	$43.87
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	360	360	$220.00	$160.67
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	282	250	$1500.00	$457.89
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	185	174	$975.00	$656.13
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	147	139	$150.00	$124.03
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	142	134	$1100.00	$411.99
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	136	95	$550.00	$398.58
14302 Repair of wound by transferring skin, each additional 30.0 sq cm	98	47	$500.00	$200.06
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	91	86	$1600.00	$1052.93
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	76	66	$600.00	$122.86
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	64	64	$1600.00	$486.29
13133 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less	62	55	$1200.00	$164.28
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	43	42	$1000.00	$388.89
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	43	40	$975.00	$606.90
15271 Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less	40	15	$200.00	$149.54
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	39	39	$3000.00	$969.56
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	30	30	$2550.00	$973.91
13102 Complicated repair of wound of trunk, each additional 5.0 cm or less	28	25	$600.00	$113.82
11102 Tangential biopsy of single skin lesion	20	19	$300.00	$81.74
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	15	14	$550.00	$384.66
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	11	11	$2325.00	$899.51

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q4121 Theraskin, per square centimeter	4,564	25	$45.00	$43.45
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	370	370	$220.00	$163.67
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	334	301	$1500.00	$467.04
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	175	164	$975.00	$656.60
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	153	142	$150.00	$125.33
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	144	131	$1100.00	$420.25
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	127	82	$550.00	$403.72
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	87	86	$1600.00	$488.29
15275 Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less	84	16	$250.00	$149.30
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	48	44	$975.00	$615.61
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	45	45	$3000.00	$971.85
15271 Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less	43	11	$200.00	$152.32
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	39	38	$1600.00	$1057.33
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	39	38	$1000.00	$378.69
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	36	32	$600.00	$125.13
13133 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less	33	32	$1200.00	$165.34
14302 Repair of wound by transferring skin, each additional 30.0 sq cm	26	13	$500.00	$207.30
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	25	24	$2550.00	$975.86
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	23	17	$550.00	$386.15
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	18	18	$2325.00	$901.50
11102 Tangential biopsy of single skin lesion	18	16	$300.00	$93.00
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	17	16	$2250.00	$750.43
88342 Special stained specimen slides to examine tissue, initial procedure	15	12	$300.00	$99.12
13102 Complicated repair of wound of trunk, each additional 5.0 cm or less	11	11	$600.00	$115.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q4121 Theraskin, per square centimeter	1,443	17	$45.00	$43.63
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	390	390	$220.00	$163.12
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	332	293	$1500.00	$469.91
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	216	198	$975.00	$657.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	198	183	$148.99	$126.48
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	168	146	$1100.00	$428.05
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	119	90	$550.00	$400.84
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	67	66	$1600.00	$498.41
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	65	64	$3000.00	$971.11
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	56	50	$975.00	$617.87
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	35	33	$1000.00	$394.29
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	32	32	$2325.00	$901.69
13133 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less	28	27	$1200.00	$168.40
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	28	28	$600.00	$127.51
11102 Tangential biopsy of single skin lesion	26	25	$300.00	$90.63
15275 Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less	23	11	$250.00	$157.70
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	21	21	$2550.00	$977.16
88342 Special stained specimen slides to examine tissue, initial procedure	21	19	$300.00	$102.57
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	15	15	$2250.00	$750.25
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$150.00	$109.50
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	13	11	$1430.00	$844.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	299	299	$150.00	$102.64
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	229	214	$1500.00	$469.44
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	123	113	$1100.00	$426.04
99213 Established patient office or other outpatient visit, typically 15 minutes	97	93	$100.52	$71.83
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	85	84	$130.00	$105.14
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	71	65	$975.00	$621.21
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	56	35	$550.00	$393.29
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	54	52	$3000.00	$989.06
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	49	48	$1600.00	$493.57
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	39	37	$2325.00	$901.80
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	36	34	$1000.00	$396.37
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	23	23	$2250.00	$759.69
99202 New patient office or other outpatient visit, typically 20 minutes	21	21	$100.00	$70.56
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	15	15	$975.00	$616.25
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	14	11	$600.00	$129.64
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	12	12	$1430.00	$854.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	288	246	$1281.25	$464.35
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	261	261	$150.00	$104.86
99213 Established patient office or other outpatient visit, typically 15 minutes	198	188	$98.79	$71.50
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	168	154	$975.00	$640.46
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	116	105	$948.28	$410.96
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	90	61	$550.00	$384.00
99202 New patient office or other outpatient visit, typically 20 minutes	81	81	$100.00	$73.66
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	55	54	$2100.00	$751.32
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	52	49	$1967.31	$903.35
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	45	44	$844.44	$388.66
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	41	41	$2634.15	$964.52
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	29	28	$975.00	$605.95
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	21	21	$1447.62	$495.41
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	15	15	$1430.00	$848.57
13133 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less	15	14	$880.00	$173.53
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	14	14	$471.43	$129.26
13102 Complicated repair of wound of trunk, each additional 5.0 cm or less	12	12	$475.00	$118.19
11102 Tangential biopsy of single skin lesion	12	12	$275.00	$91.33
13131 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm	11	11	$909.09	$350.32

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	968	776	$973.99	$623.89
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	581	374	$551.89	$371.55
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	254	254	$150.00	$103.21
99213 Established patient office or other outpatient visit, typically 15 minutes	226	213	$85.00	$70.02
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	211	188	$975.00	$587.37
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	74	74	$220.00	$157.67
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	58	56	$750.00	$457.59
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	57	49	$550.00	$355.57
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	35	34	$550.00	$404.01
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	19	18	$500.00	$359.72
11100 Biopsy of single growth of skin and/or tissue	17	16	$150.00	$86.14
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	13	13	$1500.00	$749.08
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	12	12	$1550.00	$908.73
99202 New patient office or other outpatient visit, typically 20 minutes	12	12	$100.00	$72.08
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	11	11	$2000.00	$977.45

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	684	576	$1001.64	$620.85
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	434	287	$565.75	$367.50
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	199	199	$150.00	$102.99
99213 Established patient office or other outpatient visit, typically 15 minutes	159	152	$88.02	$69.73
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	144	144	$220.00	$156.18
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	143	138	$751.47	$430.73
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	138	127	$984.13	$584.41
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	49	46	$580.61	$368.21
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	32	30	$570.31	$353.15
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	22	20	$535.00	$341.17
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	21	20	$800.00	$470.94
17000 Destruction of skin growth	17	17	$152.94	$37.17
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	16	$130.00	$102.74
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	13	13	$2000.00	$970.52
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	13	13	$1700.00	$894.57

Medical Specialties & State Licenses

CMS Verified: 2022-05-26

Dermatology - MOHS-Micrographic Surgery Primary Specialty

NUCC Taxonomy Code: 207ND0101X

State License TX L2052

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

Dermatology

NUCC Taxonomy Code: 207N00000X

State License TX L2052

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

143174403 (TX)

Medicaid State Provider ID

126640100 (TX)

Medicaid State Provider ID

E3288 (NM)

Medicaid State Provider ID

100072980A (OK)

Medicaid State Provider ID

201032275 (NM)

Medicaid State Provider ID

143174401 (TX)

Commercial Insurance / Payer ID Firstcare Commercial

126640101 (TX)

Commercial Insurance / Payer ID Hmo Blue

84412Z

Commercial Insurance / Payer ID Triwest

A491

Commercial Insurance / Payer ID Presbyterian Commercial

201032275 (NM)

Practice Associates & Co-Workers

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

2 Associated Practitioners

Dr. Gunjan Modi , MD

Dermatology - MOHS-Micrographic Surgery

NPI 1356589204

Doctor of Medicine (M.D.)

Dr. Edward Parry , MD

Dermatology - MOHS-Micrographic Surgery

NPI 1740203678

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

14 Historical Events

📍

Updated Practice Location July 11, 2018

Registered at 6100 WINDHAVEN PKWY, PLANO, TX 75093 (Tel: 9723780620)

✅

NPI Profile Active April 11, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location April 11, 2017

Registered at 6100 WINDHAVEN PKWY, PLANO, TX 750938046 (Tel: 9723780620)

📍

Updated Business Mailing Address April 11, 2017

Registered at 6100 WINDHAVEN PKWY, PLANO, TX 750938046 (Tel: 9723780620)

👤

Provider Name / Credentials Updated April 11, 2017

Recorded as MICHAEL WELLS, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 11, 2017

Dermatology (License #L2052 in TX)

📍

Updated Practice Location March 13, 2017

Registered at 6100 WINDHAVEN PKWY, PLANO, TX 750938046 (Tel: 9723780620)

📍

Updated Business Mailing Address March 13, 2017

Registered at 6100 WINDHAVEN PKWY, PLANO, TX 750938046 (Tel: 9723780620)

✅

NPI Profile Active November 16, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location November 16, 2011

Registered at 5026 TENNYSON PKWY, PLANO, TX 750243002 (Tel: 9729851920)

📍

Updated Business Mailing Address November 16, 2011

Registered at 5026 TENNYSON PKWY, PLANO, TX 750243002 (Tel: 9729851920)

👤

Provider Name / Credentials Updated November 16, 2011

Recorded as MICHAEL WELLS, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 16, 2011

Dermatology (License #L2052 in TX)

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Initial NPI Registration & Enumeration June 01, 2005

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1790787067

Entity Type:

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

Enumeration Date: June 01, 2005

Last Update: May 26, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

6100 Windhaven Pkwy

Plano, TX 750938046

Phone: 9723780620

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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