Kimberly Ann Hagopian

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024191062 Issued in VA

Practice address

8081 Innovation Park Dr
Fairfax, VA 22031-4867

Phone

(443) 852-1665

NPI assigned

Aug 27, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA, MD3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Marymount University, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

On Site Dermatology Associates LLCGroup PAC ID 6406039973, 5 clinicians

On Site Dermatology LLCGroup PAC ID 5991736837, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• On Site Dermatology Associates LLC

  • Dermatology Physician
  • Parkville, MD
  • NPI 1306154794

  DC

  Medicare reassignment Care Compare group NPD
• On Site Dermatology LLC

  • Dermatology Physician
  • Boca Raton, FL
  • NPI 1215978713

  DC, VA

  Medicare reassignment Care Compare group NPD
• Integrated Dermatology of Tidewater LLC

  • Dermatology Physician
  • Norfolk, VA
  • NPI 1801238472
  NPD

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

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1396579090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 INNOVATION PARK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314867",
            "telephone_number": "572-472-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 INNOVATION PARK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314867",
            "telephone_number": "443-852-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGOPIAN",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024191062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon H Hafner, MD
• Nancy Hafner, M.D.
• Florence Hagan, NP
• Rachel Hagen
• Beth Hagler
• Selamawit Hagos, LBA, BCBA
• Suraiya Kureshi Haider, MD
• Umme Batool Haider
• Walena G Haider
• Rebekah Haile, ED.S.

• Family Nurse Practitioner in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.