Organization Active NPI

Premier Dermatology, P.C.

  • Dermatology Physician
  • Ashburn, VA
National Provider Identifier
1275723843
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101237514 Issued in VA
Legal business name
PREMIER DERMATOLOGY, P.C.
Practice address
44121 Harry Byrd Hwy
Suite 210
Ashburn, VA 20147-5667
Phone
(703) 726-0070
Fax
(703) 726-0935
NPI assigned
Jul 30, 2007
Last updated
Jan 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Authorized official

Name
Adil Usman, M.D.NPI 1932238037
Title
President
Phone
(703) 994-2406

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 0101237514 VA Primary

Addresses

Primary practice location

44121 Harry Byrd Hwy
Suite 210
Ashburn, VA 20147-5667

Mailing address

44121 Harry Byrd Hwy
Suite 210
Ashburn, VA 20147-5667
Phone (703) 726-0070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080721000689 VA Part B Supplier - Clinic/Group Practice 8527131788 Receives reassigned benefits from 7 practitioners
Practice locations: Purcellville, VA; Winchester, VA; Front Royal, VA; Ashburn, VA

National Provider Directory

National Provider Directory

Locations

44121 Leesburg Pike
Ste 210
Ashburn, VA 20147
Phone (703) 726-0070

400 N Royal Ave
Front Royal, VA 22630
Phone (703) 726-0070

201 N Maple Ave
Unit 201
Purcellville, VA 20132
Phone (540) 751-8389

480 W Jubal Early Dr
Ste 230
Winchester, VA 22601
Phone (703) 726-0070

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1275723843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44121 HARRY BYRD HWY",
            "address_2": "SUITE 210",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475667",
            "telephone_number": "703-726-0070",
            "fax_number": "703-726-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44121 HARRY BYRD HWY",
            "address_2": "SUITE 210",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475667",
            "telephone_number": "703-726-0070",
            "fax_number": "703-726-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "USMAN",
        "authorized_official_first_name": "ADIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-994-2406",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101237514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.