Amor Khachemoune, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

237528 Issued in NY

Practice address

1117 Brentfield Dr
MC Lean, VA 22101-2913

Phone

(703) 748-6965

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 12

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, WV, DC3 enrollments

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 3

Specialty

Dermatology

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Dermatology PCGroup PAC ID 8527131788, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.14 of 100Reported as group

Quality

58.33

Improvement activities

40

Cost

89.36

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Premier Dermatology, P.C.

  • Dermatology Physician
  • Ashburn, VA
  • NPI 1275723843
  Medicare reassignment Care Compare group NPD
• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984

  VA

  Medicare reassignment
• Maryland Surgical Care PC

  • Vascular Surgery Physician
  • Frederick, MD
  • NPI 1336245075
  NPD (past)
• New York University Medical Center

  • Procedural Dermatology Physician
  • New York, NY
  • NPI 1982715272
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1326154253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 BRENTFIELD DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221012913",
            "telephone_number": "703-748-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 BRENTFIELD DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221012913",
            "telephone_number": "703-748-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHACHEMOUNE",
        "first_name": "AMOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "237528",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101242445",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "VA",
            "license": "0101242445",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "VA",
            "license": "0101242445",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "VA",
            "license": "0101242445",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "237528",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NY",
            "license": "237528",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NY",
            "license": "237528",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WV",
            "license": "27320",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "WV",
            "license": "27320",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WV",
            "license": "27320",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "WV",
            "license": "27320",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in MC Lean, VA
• Providers in MC Lean, 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 1, 2017; 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.