Active NPI
Barry Michael Shmookler, MD
- Dermatopathology (Pathology) Physician
- Fairfax, VA
National Provider Identifier
1407802572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatopathology (Pathology) Physician
- License
- D0021961
- Practice address
- 3600 Joseph Siewick Dr
Fairfax, VA 22033-1709 - Phone
- (703) 391-3654
- Fax
- (703) 391-3049
- NPI assigned
- May 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatopathology (Pathology) Physician | 207ZD0900X | D0021961 | MD | Primary |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | D0021961 | MD |
Addresses
Primary practice location
3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Mailing address
753 Johnnie Dodds Blvd
Mt Pleasant, SC 29464-3054
Phone (843) 284-3400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D0021961 | Other | MD | MD MEDICAL LICENSE # |
| MD13872 | Other | DC | DC MEDICAL LICENSE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0021961 | MD | MD | Anatomic Pathology & Clinical Pathology Physician |
| 13872 | DC | MD | Home Health Aide |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diagnosti Pathology Services, Inc | Past | Accepting new patients | |
| William I Smith, Jr. MD PC | Dermatopathology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Medical Laboratory
- Clarksburg, MD
- NPI 1609821248
-
- Anatomic Pathology & Clinical Pathology Physician
- Bethesda, MD
- NPI 1114960655
Dermatopathology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1407802572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "753 JOHNNIE DODDS BLVD",
"city": "MT PLEASANT",
"state": "SC",
"postal_code": "294643054",
"telephone_number": "843-284-3400",
"fax_number": "843-284-3401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 JOSEPH SIEWICK DR",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220331709",
"telephone_number": "703-391-3654",
"fax_number": "703-391-3049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHMOOKLER",
"first_name": "BARRY",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207ZD0900X",
"taxonomy_group": "",
"desc": "Pathology, Dermatopathology",
"state": "MD",
"license": "D0021961",
"primary": true
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "MD",
"license": "D0021961",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MD MEDICAL LICENSE #",
"identifier": "D0021961",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DC MEDICAL LICENSE #",
"identifier": "MD13872",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.