Joselin D Tacastacas, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0101236219 Issued in VA

Practice address

1601 Commonwealth Ave
Williamsburg, VA 23185-5125

Phone

(757) 259-9466

Fax

(757) 259-7907

NPI assigned

May 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 6

Electronic endpoints 1

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

Specialty

Dermatology

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peninsula Dermatology Skin Cancer Surgery Center, IncGroup PAC ID 4486749223, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jtacastacas@directaddress.net

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

• Peninsula Dermatology Skin Cancer Surgery Center, Inc

  • Dermatology Physician
  • Newport News, VA
  • NPI 1063524593
  Medicare reassignment Care Compare group NPD
• Peninsula Dermatology Skin Cancer Surgery Center, Inc

  • Dermatology Physician
  • Williamsburg, VA
  • NPI 1205993383
  NPD
• Alexander Rabinovich Medical PC

  • Ophthalmology Physician
  • Brooklyn, NY
  • NPI 1962735589
  NPD (past)

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1184673295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11844 ROCK LANDING DR STE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064206",
            "telephone_number": "757-873-0161",
            "fax_number": "757-873-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 COMMONWEALTH AVE",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855125",
            "telephone_number": "757-259-9466",
            "fax_number": "757-259-7907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11844 Rock Landing Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064206",
            "country_code": "US",
            "telephone_number": "757-873-0161",
            "fax_number": "757-873-0205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TACASTACAS",
        "first_name": "JOSELIN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "010236219",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD28115",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101236219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "177346",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "VA0105",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "010087000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010110831",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010110866",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010158192",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtacastacas@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Peninsula Dermatology Skin Cancer Surgery Center, Inc",
            "address_1": "475 McLaws Circle",
            "address_2": "Suite One",
            "city": "Williamsburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "23185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Blair Sweeney, PT, DPT
• Ashley Sweet, LPC, LMHC
• Shahrukh Syed
• Lynne Szewczyk, LPC MA NCC
• Samuel Anthony John Tabacchi, DO
• Stacey Harris Tadlock, FNP-BC
• Dylan T Tagg, DMD
• Felicia Tai
• Katherine Rae Tajirian, PT, DPT
• Kelly G Tanner, RDH

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.