Individual provider Active NPI

Clarisa C. Hammer, DO

  • Plastic and Reconstructive Surgery Physician
  • Alexandria, VA
National Provider Identifier
1386764504
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
0102203916 Issued in VA
Practice address
4660 Kenmore Ave Ste 220
Alexandria, VA 22304-1306
Phone
(703) 832-4000
Fax
(703) 832-4001
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 34009035 OH
Surgery Physician 208600000X 20A10466 CA
Surgery Physician 208600000X H75038 MD
Plastic and Reconstructive Surgery Physician 2086S0122X 0102203916 VA Primary

Addresses

Primary practice location

4660 Kenmore Ave Ste 220
Alexandria, VA 22304-1306

Mailing address

4660 Kenmore Ave Ste 220
Alexandria, VA 22304-1306
Phone (703) 832-4000

Other identifiers 3

IdentifierTypeStateIssuer
2760007MedicaidOH
334516500MedicaidMD
20A104660OtherCABLUE SHIELD PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20121211000019 DC Practitioner - Plastic and Reconstructive SurgeryPractitioner - General Surgery 4082705058 Reassigns benefits to 1 organization
I20180411001362 VA Practitioner - Plastic and Reconstructive Surgery 4082705058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Lake Erie College of Osteopathic Medicine, Erie, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affiliates in Plastic Surgery LLCGroup PAC ID 2365664117, 11 clinicians
Suburban/NRH Medical Rehabilitation IncGroup PAC ID 6507846771, 885 clinicians

Practice addresses (Care Compare)

2200 Opitz Blvd
Suite 250
Woodbridge, VA 22191-3351
Phone (703) 832-4000

2296 Opitz Blvd
Suite 280
Woodbridge, VA 22191-3353

4660 Kenmore Ave
Suite 220
Alexandria, VA 22304-1306
Phone (703) 888-2034

6410 Rockledge Dr
Bethesda, MD 20817-1844

6801 Whittier Ave
Suite 301
MC Lean, VA 22101-4549
Phone (703) 832-4000

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063
  • Inova Alexandria Hospital Hospital, Alexandria, VA, CCN 490040

Merit-based Incentive Payment System (MIPS)

Final score
91.86 of 100Reported as group
Quality
100
Improvement activities
40
Cost
72.87

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy14
Melanoma (skin cancer) excision16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Surgeons, Inc. Surgery Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1386764504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE STE 220",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041306",
            "telephone_number": "703-832-4000",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE STE 220",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041306",
            "telephone_number": "703-832-4000",
            "fax_number": "703-832-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMER",
        "first_name": "CLARISA",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "34009035",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "20A10466",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "H75038",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "VA",
            "license": "0102203916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2760007",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "334516500",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NUMBER",
            "identifier": "20A104660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.