Individual provider Active NPI

Abrahem Kazemi, MD

  • Dermatology Physician
  • Centreville, VA
National Provider Identifier
1700383585
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101275044 Issued in VA
Practice address
6101 Redwood Square Ctr Ste 117
Centreville, VA 20121-4266
Phone
(338) 257-7546
NPI assigned
Apr 9, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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 0101275044 VA Primary

Addresses

Primary practice location

6101 Redwood Square Ctr Ste 117
Centreville, VA 20121-4266

Mailing address

PO Box 734240
Chicago, IL 60673-4240
Phone (708) 634-4602

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
I20220511002352 VA Practitioner - Dermatology 0840677993 Reassigns benefits to 1 organization
I20220512002288 DC Practitioner - Dermatology 0840677993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Howard University College of Medicine, 2018
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)

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

385 Garrisonville Rd
Suite 205
Stafford, VA 22554-1599
Phone (815) 744-8554

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) excision1-10
Removal of skin lesions394
Removal or shaving of skin growth1-10
Skin biopsy67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101275044VAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Dermatology, SC Dermatology CurrentSince May 1, 2022 Accepting new patients
Virginia Dermatology and Skin Surgery Center PastSince Jul 1, 2021 Accepting new patients

Locations

820 Springer Dr
Lombard, IL 60148
Phone (708) 634-4602

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: abrahem.kazemi@qdp.emadirect.md
  • Direct secure messaging: abrahemkazemi@pinnacleskin.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1700383585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 734240",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606734240",
            "telephone_number": "708-634-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 REDWOOD SQUARE CTR STE 117",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201214266",
            "telephone_number": "338-257-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZEMI",
        "first_name": "ABRAHEM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101275044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, VA

Sources for this page

Verify at the official NPI Registry.