Individual provider Active NPI

Arnold R Oppenheim, M.D.

  • Dermatology Physician
  • Virginia Beach, VA
National Provider Identifier
1649356940
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
D0087639 Issued in MD
Practice address
5320 Providence Rd Ste 202
Virginia Beach, VA 23464-4122
Phone
(757) 523-4800
Fax
(757) 523-5857
NPI assigned
Oct 29, 2006
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X D0087639 MD Primary
Specialist 174400000X 0101033623 VA

Addresses

Primary practice location

5320 Providence Rd Ste 202
Virginia Beach, VA 23464-4122

Mailing address

3729 Redwood Farm Dr
Virginia Beach, VA 23452-4640
Phone (757) 498-1356

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, FL2 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
I20080401000417 VA Practitioner - Dermatology 1355428343 Reassigns benefits to 1 organization
I20220126002912 FL Practitioner - Dermatology 1355428343 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101033623VAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Dermatology, P.C. Specialist CurrentSince Jan 4, 2017 Accepting new patients
Complete Dermatology of Virginia, Inc. Specialist CurrentSince Jan 1, 2020 Accepting new patients
Dermatology of Pompano LLC Single Specialty CurrentSince Jan 13, 2022 Accepting new patients
Virginia Beach Dermatoloty Ass. Specialist Current Accepting new patients

Locations

2040 NE 36th St
Lighthouse Point, FL 33064
Phone (954) 296-5108

1800 N Federal Hwy
Ste 105
Pompano Beach, FL 33062
Phone (754) 999-1746

10721 Main St
Ste 3100
Fairfax, VA 22030
Phone (703) 352-2620

1600 N Coalter St
Ste 19
Staunton, VA 24401
Phone (540) 885-4500

5320 Providence Rd
Ste 202
Virginia Beach, VA 23464
Phone (757) 523-4800

Organizations & group practices 4

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": "1162080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1649356940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3729 REDWOOD FARM DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234524640",
            "telephone_number": "757-498-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 PROVIDENCE RD STE 202",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644122",
            "telephone_number": "757-523-4800",
            "fax_number": "757-523-5857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPPENHEIM",
        "first_name": "ARNOLD",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-29",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0087639",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101033623",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.