Pure Dermatology and Cosmetic Center LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PURE DERMATOLOGY AND COSMETIC CENTER LLC

Practice address

8401 Connecticut Ave Ste 460
Chevy Chase, MD 20815-5803

Phone

(240) 600-1682

NPI assigned

Nov 17, 2020

Last updated

Jul 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angela Lotsikas, MDNPI 1922055102

Title

Owner

Phone

(240) 600-1682

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angela Joy Lotsikas, M.D.

  • Dermatology Physician
  • Chevy Chase, MD
  • NPI 1922055102

  DC

  Medicare reassignment NPD Authorized official
• Garry Carroll Jelen, P.A.-C

  • Physician Assistant
  • Ashburn, VA
  • NPI 1619249950

  DC

  Medicare reassignment

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1740883354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 CONNECTICUT AVE STE 460",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208155803",
            "telephone_number": "240-600-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 CONNECTICUT AVE STE 460",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208155803",
            "telephone_number": "240-600-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE DERMATOLOGY AND COSMETIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-17",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "LOTSIKAS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-600-1682",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Privia Medical Group, LLC
• Privia Medical Group, LLC
• Privia Medical Group, LLC
• Eugenia Prokopets, D.D.S. M.S.D
• Paul George Prunier, M.D.
• Keriki Purkiss
• Israel Puterman, DMD MSD
• Jared Putnam, M.D.
• Jerome Stuart Putnam, M.D.
• Samantha Quackenbush, LGPC

• Dermatology Physician in Chevy Chase, MD
• Providers in Chevy Chase, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.