Individual provider Active NPI

Naiem Tony Issa, M.D., PH.D.

  • Dermatology Physician
  • Vienna, VA
National Provider Identifier
1386170769
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101275106 Issued in VA
Practice address
8301 Old Courthouse Rd
Vienna, VA 22182-3804
Phone
(703) 442-0300
Fax
(703) 442-0337
NPI assigned
May 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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 0101275106 VA Primary

Addresses

Primary practice location

8301 Old Courthouse Rd
Vienna, VA 22182-3804

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Naiem.Issa@forefrontdermatology.emadirect.md

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220720003289 DC Practitioner - Dermatology 1153702238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Georgetown University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

8301 Old Courthouse Rd
Vienna, VA 22182-3804
Phone (703) 442-0300

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision79
Removal of skin lesions2062
Removal or shaving of skin growth41
Skin biopsy640

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101275106VAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. Dermatology Current Accepting new patients
Forefront Dermatology, S.C. Dermatology CurrentSince Jun 11, 2022 Accepting new patients
Forefront Dermatology, S.C. Dermatology CurrentSince Jun 11, 2022 Accepting new patients
Forefront Dermatology, S.C. Dermatology Past Accepting new patients

Locations

8301 Old Courthouse Rd
Vienna, VA 22182
Phone (703) 442-0300

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1386170769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 OLD COURTHOUSE RD",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823804",
            "telephone_number": "703-442-0300",
            "fax_number": "703-442-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISSA",
        "first_name": "NAIEM",
        "middle_name": "TONY",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-04",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101275106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Naiem.Issa@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "8301 Old Courthouse Rd",
            "city": "Vienna",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221823804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

Verify at the official NPI Registry.