Individual provider Active NPI

Andrew Jafar Ghassemian

  • Dermatology Physician
  • Raleigh, NC
National Provider Identifier
1760687370
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
2010-00585 Issued in NC
Practice address
10931 Raven Ridge Rd
Ste 101
Raleigh, NC 27614-6499
Phone
(919) 870-6600
Fax
(919) 870-1610
NPI assigned
Jun 15, 2007
Last updated
Jun 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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 2010-00585 NC Primary

Addresses

Primary practice location

10931 Raven Ridge Rd
Ste 101
Raleigh, NC 27614-6499

Mailing address

PO Box 23329
New York, NY 10087-3329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100727001110 NC Practitioner - Dermatology 1850424847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Brody School of Medicine at East Carolina University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Dermatology PAGroup PAC ID 7012971609, 52 clinicians

Practice addresses (Care Compare)

10931 Raven Ridge Rd
Suite 101
Raleigh, NC 27614-6499
Phone (919) 870-6600

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1099
Removal or shaving of skin growth1-10
Skin biopsy289

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010-00585NCMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Dermatology, P.a. CurrentSince Oct 1, 2019 Accepting new patients

Locations

10931 Raven Ridge Rd
Ste 101
Raleigh, NC 27614
Phone (919) 870-6600

4201 Lake Boone Trl
Ste 200
Raleigh, NC 27607
Phone (919) 782-2152

123 Fox Rd
Knoxville, TN 37922
Phone (865) 342-5811

Interoperability endpoints

  • Direct secure messaging: aghassemian@aadermaffiliates.emadirect.md

Organizations & group practices 1

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": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1760687370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23329",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10931 RAVEN RIDGE RD",
            "address_2": "STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276146499",
            "telephone_number": "919-870-6600",
            "fax_number": "919-870-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHASSEMIAN",
        "first_name": "ANDREW",
        "middle_name": "JAFAR",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "2010-00585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.