Individual provider Active NPI

Barry Michael Shmookler, MD

  • Dermatopathology (Pathology) Physician
  • Fairfax, VA
National Provider Identifier
1407802572
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
D0021961 Issued in MD
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

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
D0021961OtherMDMD MEDICAL LICENSE #
MD13872OtherDCDC 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

LicenseStateTypeSpecialty
D0021961MDMDAnatomic Pathology & Clinical Pathology Physician
13872DCMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.