Potomac Dermatology and Skincare Center

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

POTOMAC DERMATOLOGY AND SKINCARE CENTER

Practice address

9812 Falls Rd Ste 124
Potomac, MD 20854-3976

Phone

(703) 356-1111

NPI assigned

Mar 14, 2022

Last updated

Apr 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lily Talakoub, MDNPI 1801929773

Title

Owner

Phone

(703) 626-3648

Specialties & licenses 1

Addresses

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 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lily Talakoub, M.D.

  • Dermatology Physician
  • McLean, VA
  • NPI 1801929773

  DC

  Medicare reassignment Care Compare group NPD Authorized official
• Kaitlyn Mula Schiavone, D.O.

  • Dermatology Physician
  • Bethesda, MD
  • NPI 1245643477

  DC

  Medicare reassignment Care Compare group NPD
• Amanda Lezanski-Gujda, D.O.

  • Dermatology Physician
  • Haverford, PA
  • NPI 1760809891

  DC

  Medicare reassignment Care Compare group NPD
• Kathryn R Barbante, M.D.

  • Dermatology Physician
  • Bethesda, MD
  • NPI 1386084762

  DC

  Medicare reassignment Care Compare group
• Alysha Guillermina Colon, MD

  • Dermatology Physician
  • Alexandria, VA
  • NPI 1003444365

  DC

  Medicare reassignment
• Michelle Bongiorno, M.D.

  • MOHS-Micrographic Surgery Physician
  • Bethesda, MD
  • NPI 1730506890
  Care Compare group
• Nadia Peritsalis Herrera, PA

  • Physician Assistant
  • McLean, VA
  • NPI 1649548801
  NPD
• Jennifer Djorup Spyridakis

  • Family Nurse Practitioner
  • McLean, VA
  • NPI 1275105314
  NPD
• Sarah Aimee Walker, FNP-BC

  • Family Nurse Practitioner
  • McLean, VA
  • NPI 1184177487
  NPD
• Isabela Tollini Jones, M.D.

  • Dermatology Physician
  • McLean, VA
  • NPI 1790041853
  NPD (past)
• Lauren Wurster, FNP

  • Family Nurse Practitioner
  • Vienna, VA
  • NPI 1609200336
  NPD (past)

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1215685896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6849 OLD DOMINION DR STE 450",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013718",
            "telephone_number": "703-626-3648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9812 FALLS RD STE 124",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208543976",
            "telephone_number": "703-356-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC DERMATOLOGY AND SKINCARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "TALAKOUB",
        "authorized_official_first_name": "LILY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-626-3648",
        "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": []
}

• Polun American Surgery Center, PC (American Surgery Center)
• Franklin Randall Polun, DPM
• Mihael H Polymeropoulos, MD
• Positive Behavioral Practice, Inc
• Potomac Acuclinic LLC
• Potomac Eldercare Physicians
• Potomac Eye Surgeons PA
• Potomac Feeding and Speech LLC
• Potomac Medical Aesthetics, LLC
• Potomac on Call LLC (Potomac ElderCare Physicians)

• Dermatology Physician in Potomac, MD
• Providers in Potomac, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.