NPIMap

Individual provider Active NPI

Camille A Haisley-Royster, MD

  • Dermatology Physician
  • Richmond, VA
National Provider Identifier
1366404816
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101233942 Issued in VA
Practice address
7001 Forest Ave Ste 400
Richmond, VA 23230-1726
Phone
(804) 282-0831
Fax
(804) 288-7135
NPI assigned
Apr 3, 2006
Last updated
Oct 25, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0101233942 VA Primary

Addresses

Primary practice location

7001 Forest Ave Ste 400
Richmond, VA 23230-1726

Mailing address

7001 Forest Ave Ste 400
Richmond, VA 23230-1726
Phone (804) 282-0831

Other identifiers 1

IdentifierTypeStateIssuer
005901235MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100818001109 VA Practitioner - Dermatology 9133253651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Duke University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Dermatology PCGroup PAC ID 6002872553, 14 clinicians

Practice addresses (Care Compare)

7001 Forest Ave
Suite 400
Richmond, VA 23230-1726
Phone (804) 282-0831

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1197
Removal or shaving of skin growth12
Skin biopsy449

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101233942VAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Dermatology, PC Dermatology CurrentSince May 1, 2003 Accepting new patients

Locations

7001 Forest Ave
Ste 300
Richmond, VA 23230
Phone (804) 282-0831

7001 Forest Ave
Ste 400
Richmond, VA 23230
Phone (804) 282-0831

Organizations & group practices 1

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1366404816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 FOREST AVE STE 400",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232301726",
            "telephone_number": "804-282-0831",
            "fax_number": "804-288-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 FOREST AVE STE 400",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232301726",
            "telephone_number": "804-282-0831",
            "fax_number": "804-288-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAISLEY-ROYSTER",
        "first_name": "CAMILLE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101233942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005901235",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.