Mohammad-Ali Yazdani Abyaneh

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0101286129 Issued in VA

Practice address

2296 Opitz Blvd Ste 250
Woodbridge, VA 22191-3345

Phone

(703) 844-4267

Fax

(703) 982-7238

NPI assigned

Apr 14, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY, 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

Specialty

Dermatology

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Slocum Dickson Medical Group PLLCGroup PAC ID 5799778510, 79 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wynn Hospital Hospital, Utica, NY, CCN 330044

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: myazdaniabyaneh55924@mvhealthsystem.direct-ci.com

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.

• Aria Dermatology LLC

  • Dermatology Physician
  • Woodbridge, VA
  • NPI 1174494207
  Medicare reassignment NPD Authorized official
• Slocum Dickson Medical Group PLLC

  • Clinic/Center
  • New Hartford, NY
  • NPI 1285625996
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• MVHS Inc

  • General Acute Care Hospital
  • Utica, NY
  • NPI 1205877172
  Care Compare affiliation

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1508252784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 BURRSTONE RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131001",
            "telephone_number": "315-798-1832",
            "fax_number": "315-798-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2296 OPITZ BLVD STE 250",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913345",
            "telephone_number": "703-844-4267",
            "fax_number": "703-982-7238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1729 Burrstone Rd",
            "address_purpose": "LOCATION",
            "city": "New Hartford",
            "state": "NY",
            "postal_code": "134131001",
            "country_code": "US",
            "telephone_number": "315-798-1832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAZDANI ABYANEH",
        "first_name": "MOHAMMAD-ALI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "299230",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101286129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30018441370001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellen Marie Yach, LPTA
• Anastasiya Puritz Yakovenko, MD
• Ethna Yambasu
• Megan Yannessa
• George Matthew Yasenosky, PT, DPT
• Kambiz Yazdani, M.D.
• Jisun Yi, MD
• Ykim Dental
• Yogi Dental PLLC
• Young-a Yoo, DDS

• Dermatology Physician in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; 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.