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Dr. Mary Evans Dickerson , MD

Dermatology β€’ Springfield, IL

Active NPI 1780377697 Individual Practitioner Female Practitioner
Practice location in NPPES

751 N Rutledge St Ste 2300
Springfield, IL 627024968

Call 2175458000 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

751 N Rutledge St Ste 2300

Springfield, IL 627024968

Telephone 2175458000
Organization at the Same NPPES Address or Phone
Siu Physicians & Surgeons, Inc Facility NPI 1164055976

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

30-day fills

61 standardized 30-day fills in 2024

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$1,435 in 2024

The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024.

Open Payments general payments, program year 2025

All general payments: $216.21 across 2 records.

By nature of payment

  • Food and Beverage: $116.22 across 1 record.
  • Education: $99.99 across 1 record.

Reporting-company totals

  • ABBVIE INC.: $116.22 across 1 record.
  • Janssen Pharmaceuticals, Inc: $99.99 across 1 record.

A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.

See the full table

Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).

Guide: How to read an Open Payments record

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Dickerson has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Dickerson as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Springfield and Illinois

Billing and prescribing volume is not a quality rating.

Medicare Part D prescriptions

Fewer Part D prescriptions than 70% of clinicians listed under Dermatology in Springfield, IL (2024, 22 clinicians with data). Median for this group: 490. Middle half: 34 to 1,178.

Fewer Part D prescriptions than 90% of clinicians listed under Dermatology in Illinois (2024, 468 clinicians with data). Median for this group: 471. Middle half: 165 to 904.

Part D drug cost

A lower Part D drug cost than 80% of clinicians listed under Dermatology in Springfield, IL (2024, 22 clinicians with data). Median for this group: $220,206. Middle half: $2,334 to $651,945.

A lower Part D drug cost than 85% of clinicians listed under Dermatology in Illinois (2024, 468 clinicians with data). Median for this group: $69,576. Middle half: $5,709 to $275,598.

36 active clinicians are listed under Dermatology with a practice address in Springfield, IL (647 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Springfield

0% of these 36 clinicians have the CMS telehealth indicator.

44.4% of these 36 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Medicare Part D Prescribers (2024), CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments Β· Program Year 2025
Disclosure Year:

Program year 2025 (payments made January 1 – December 31, 2025): fewer than 11 records totaling $216.21.

Manufacturer Payment Nature Product Type Amount ($)
ABBVIE INC.
Food and Beverage
In-kind items and services
NATRELLE SALINE-FILLED BREAST IMPLANTS General $116.22
Janssen Pharmaceuticals, Inc
Education
In-kind items and services
TREMFYA General $99.99

Source: CMS Open Payments, program year 2025, released June 30, 2026.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2024.

CMS Part D Β· Data Year 2024
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Triamcinolone Acetonide Triamcinolone Acetonide 30 645 $157.74 25
Ketoconazole Ketoconazole 14 443 $188.72 13
Fluorouracil Fluorouracil 14 424 $1,088.98 14

Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-08-26
Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

License # reported to NPPES IL 125082094

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

ORDER AND REFERRING ONLY - DERMATOLOGY

Medicare Enrollment ID

I20230713000402

Enrollment State Jurisdiction

IL

PECOS Control ID

4688034390

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

28 listed
Dr. Janet Albers , MD

Family Medicine

NPI 1023006913

Doctor of Medicine (M.D.)

Jay Benoit

Nurse Practitioner - Family

NPI 1003579335
Dr. Mukul Bhattarai , MD

Internal Medicine - Cardiovascular Disease

NPI 1013204262

Doctor of Medicine (M.D.)

Dr. Fadel Bofarrag , MD, MPH

Internal Medicine - Cardiovascular Disease

NPI 1003291279

Doctor of Medicine (M.D.), Master of Public Health

Dr. Basar Cenik , MD

Psychiatry & Neurology - Psychiatry

NPI 1013350446

Doctor of Medicine (M.D.)

Olivia Delay , FNP-C

Nurse Practitioner - Family

NPI 1033795992

Family Nurse Practitioner (Certified)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location August 26, 2024

Registered at 751 N RUTLEDGE ST STE 2300, SPRINGFIELD, IL 627024968 (Tel: 2175458000)

πŸ“
Updated Business Mailing Address August 26, 2024

Registered at PO BOX 19644, SPRINGFIELD, IL 627949644

βœ…
NPI Profile Active May 29, 2023

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) May 29, 2023

Registered at 301 N 8TH ST, SPRINGFIELD, IL 627011041 (Tel: 2175453134)

πŸ“
Business Mailing Address (Initial Record) May 29, 2023

Registered at 301 N 8TH ST, SPRINGFIELD, IL 627011041

πŸ‘€
Provider Name / Credentials (Initial Record) May 29, 2023

Recorded as MARY DICKERSON, MD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 29, 2023

Dermatology (license number reported to NPPES: IL 125082094)

🟒
Initial NPI Registration & Enumeration May 29, 2023

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1780377697
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 29, 2023
Last Update: August 26, 2024
Sole Proprietor: No

Other Dermatology Specialists in Springfield

All Dermatology Specialists in Springfield

Mailing Address

Po Box 19644

Springfield, IL 627949644

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.