Individual provider Active NPI

Kelly M. Cordoro

  • Dermatology Physician
  • Charlottesville, VA
National Provider Identifier
1477622090
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101237905 Issued in VA
Practice address
Lee St
Charlottesville, VA 22908-0001
Phone
(434) 924-0000
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0101237905 VA Primary

Addresses

Primary practice location

Lee St
Charlottesville, VA 22908-0001

Mailing address

500 Ray C Hunt Dr
Charlottesville, VA 22903-2981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20071210000666 CA Practitioner - Dermatology 1355382573 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.89 of 100Reported as group
Quality
81.13
Improvement activities
40
Cost
71.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
99626CAMDMental Health Counselor
0101237905VAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services Dermatology CurrentSince Sep 20, 2010 Accepting new patients
UCSF Medical Group Business Services CurrentSince Sep 20, 2010 Accepting new patients
University of California San Francisco CurrentSince Jul 1, 2007 Accepting new patients
University of California San Francisco Dermatology CurrentSince Jul 1, 2007 Accepting new patients
University of California San Francisco Current Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
University of Virginia Physicians Group PastSince Nov 1, 2017 Accepting new patients

Locations

225 California Dr
Burlingame, CA 94010
Phone (415) 353-2002

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

1600 Divisadero St
San Francisco, CA 94143
Phone (415) 353-7175

1701 Divisadero St
San Francisco, CA 94115
Phone (415) 353-7300

2001 The Embarcadero
Ste 1500
San Francisco, CA 94143
Phone (415) 353-1606

1701 Divisadero St
Fl 3
San Francisco, CA 94115
Phone (415) 353-7800

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

Interoperability endpoints

  • Direct secure messaging: kcordoro15201@direct-ucsfmedicalcenter.org

Organizations & group practices 7

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477622090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 RAY C HUNT DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229032981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080001",
            "telephone_number": "434-924-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDORO",
        "first_name": "KELLY",
        "middle_name": "M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101237905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.