Individual provider Active NPI

Connor A Patterson, M.D.

  • Procedural Dermatology Physician
  • Fredericksburg, VA
National Provider Identifier
1548475189
Registry record updated Sep 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
0101267201 Issued in VA
Practice address
1985 Jefferson Davis Hwy
Fredericksburg, VA 22401-6233
Phone
(540) 373-6647
Fax
(540) 479-1656
NPI assigned
May 14, 2007
Last updated
Sep 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD.203711 LA
Procedural Dermatology Physician 207NS0135X MD.203711 LA
Procedural Dermatology Physician 207NS0135X 0101267201 VA Primary

Addresses

Primary practice location

1985 Jefferson Davis Hwy
Fredericksburg, VA 22401-6233

Mailing address

1985 Jefferson Davis Hwy
Fredericksburg, VA 22401-6233
Phone (225) 766-5151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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

Enrollment IDStateProvider typePAC IDDetails
I20190910001326 VA Practitioner - Dermatology 1850423450 Reassigns benefits to 1 organization
I20210809002199 DC Practitioner - Dermatology 1850423450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Louisiana State University School of Medicine in New Orleans, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Dermatology SCGroup PAC ID 8628353380, 145 clinicians

Practice addresses (Care Compare)

1982 Opitz Blvd
Woodbridge, VA 22191-3304
Phone (815) 744-8554

2616 Sherwood Hall LN
Suite 306
Alexandria, VA 22306-3154
Phone (708) 780-8400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.8 of 100Reported as group
Promoting interoperability
88
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision215
Removal of skin lesions4267
Removal or shaving of skin growth168
Skin biopsy927

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Eye Care Center LLC CurrentSince Jul 1, 2010 Accepting new patients
Pinnacle Dermatology, SC Dermatology CurrentSince Dec 31, 2020 Accepting new patients

Locations

5220 Flanders Dr
Baton Rouge, LA 70808
Phone (225) 766-3437

2616 Sherwood Hall Ln
Ste 306
Alexandria, VA 22306
Phone (708) 780-8400

6101 Redwood Square Ctr
Ste 117
Centreville, VA 20121
Phone (338) 257-7546

1985 Emancipation Hwy
Fredericksburg, VA 22401
Phone (540) 373-6647

385 Garrisonville Rd
Ste 205
Stafford, VA 22554
Phone (540) 373-6647

492 Blackwell Rd
Ste 200
Warrenton, VA 20186
Phone (540) 930-0607

13875 Hedgewood Dr
Ste 210
Woodbridge, VA 22193
Phone (703) 434-3633

1982 Opitz Blvd
Woodbridge, VA 22191
Phone (540) 373-6647

Interoperability endpoints

  • Direct secure messaging: connor.patterson@qdp.emadirect.md

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567814400000",
    "number": "1548475189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1985 JEFFERSON DAVIS HWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224016233",
            "telephone_number": "225-766-5151",
            "fax_number": "225-766-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1985 JEFFERSON DAVIS HWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224016233",
            "telephone_number": "540-373-6647",
            "fax_number": "540-479-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "CONNOR",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2019-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "MD.203711",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "LA",
            "license": "MD.203711",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "VA",
            "license": "0101267201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.