Individual provider Active NPI

Merrick Douglas Kozak, M.D.

  • Dermatology Physician
  • Staunton, VA
National Provider Identifier
1003342775
Registry record updated Oct 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101272020 Issued in VA
Practice address
427 Lee Jackson Hwy Ste 101
Staunton, VA 24401-9504
Phone
(540) 458-9450
Fax
(540) 237-1815
NPI assigned
May 2, 2017
Last updated
Oct 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0101272020 VA Primary

Addresses

Primary practice location

427 Lee Jackson Hwy Ste 101
Staunton, VA 24401-9504

Mailing address

427 Lee Jackson Hwy Ste 101
Staunton, VA 24401-9504
Phone (540) 458-9450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210910001921 VA Practitioner - Dermatology 1850661182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Virginia Commonwealth University, School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shenandoah Dermatology, P.C..Group PAC ID 9739499344, 11 clinicians

Practice addresses (Care Compare)

1600 N Coalter St
Suite 19
Staunton, VA 24401-2566
Phone (540) 885-4500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.84 of 100Reported as group
Quality
80.99
Improvement activities
40
Cost
74.82

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision28
Removal of skin lesions743
Removal of nail tissue1-10
Removal or shaving of skin growth60
Skin biopsy288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0116030312VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Dermatology, P.C. CurrentSince Aug 2, 2022 Accepting new patients
Dogwood Dermatology PC Dermatology CurrentSince Sep 1, 2026 Accepting new patients

Locations

1600 N Coalter St
Ste 19
Staunton, VA 24401
Phone (540) 885-4500

427 Lee Jackson Hwy
Ste 101
Staunton, VA 24401
Phone (540) 458-9450

Interoperability endpoints

  • Direct secure messaging: merrick.kozak.1@20955.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792713600000",
    "number": "1003342775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 LEE JACKSON HWY STE 101",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244019504",
            "telephone_number": "540-458-9450",
            "fax_number": "540-237-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 LEE JACKSON HWY STE 101",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244019504",
            "telephone_number": "540-458-9450",
            "fax_number": "540-237-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "MERRICK",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-02",
        "last_updated": "2026-10-23",
        "certification_date": "2026-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101272020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staunton, VA

Sources for this page

Verify at the official NPI Registry.