Dermatology Specialists of Virginia PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY SPECIALISTS OF VIRGINIA PC

Practice address

1800 Town Center Dr
Ste 415
Reston, VA 20190

Phone

(703) 709-1492

Fax

(703) 709-5111

NPI assigned

Feb 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Theodore Stewart Sebastien, MDNPI 1568433860

Title

Ceo President

Phone

(703) 709-1492

Specialties & licenses 1

Addresses

Other names 1

• Sebastien Dermatology PC Former legal business name

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theodore Stewart Sebastien, MD

  • MOHS-Micrographic Surgery Physician
  • Reston, VA
  • NPI 1568433860

  DC, Dermatology

  Medicare reassignment NPD Authorized official
• Ilene B Bayer-Garner, MD

  • Dermatopathology Physician
  • Severna Park, MD
  • NPI 1003895764

  DC

  Medicare reassignment
• Sarah J Donovan, PA-C

  • Physician Assistant
  • Reston, VA
  • NPI 1730168899
  NPD (past)

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286409600000",
    "number": "1083688238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 TOWN CENTER DR",
            "address_2": "STE 415",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20190",
            "telephone_number": "703-709-1492",
            "fax_number": "703-709-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 TOWN CENTER DR",
            "address_2": "STE 415",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20190",
            "telephone_number": "703-709-1492",
            "fax_number": "703-709-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY SPECIALISTS OF VIRGINIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2010-10-07",
        "status": "A",
        "authorized_official_last_name": "SEBASTIEN",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "703-709-1492",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sebastien Dermatology PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kelly Delong, RNFA
• Kaitlyn Denby, ATC/L
• Jennifer Lynn Dennison, NP
• Dentart Smile Center PLLC
• Dentlux Smile Aesthetics (Reston Town Center Dental)
• Derosa Wellness Innovation, LLC
• Shirley Derosa, LPC
• Ananya Dhoundiyal
• Sarah Harwood Dial, RN, CNS
• Amy Elizabeth Diehl, BCBA

• Dermatology Physician in Reston, VA
• Providers in Reston, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.