Active NPI
Albemarle Dermatology Associates, LLC
- Dermatology Physician
- Charlottesville, VA
National Provider Identifier
1801973169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 0101042830
- Legal business name
- ALBEMARLE DERMATOLOGY ASSOCIATES, LLC
- Practice address
- 3350 Berkmar Dr
Charlottesville, VA 22901-1491 - Phone
- (434) 923-4651
- Fax
- (434) 964-3636
- NPI assigned
- Nov 1, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Bonnie F Straka, MD
- Title
- Owner/Physician
- Phone
- (434) 923-4651
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 0101042830 | VA | Primary |
Addresses
Primary practice location
3350 Berkmar Dr
Charlottesville, VA 22901-1491
Mailing address
3350 Berkmar Dr
Charlottesville, VA 22901-1491
Phone (434) 923-4651
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050906000877 | VA | Part B Supplier - Clinic/Group Practice | 5698707107 |
Receives reassigned benefits from 7 practitioners Practice locations: Charlottesville, VA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D0972053 | Albemarle Dermatology Associates and Or | Provider-performed microscopy | Jun 6, 2027 |
National Provider Directory
National Provider DirectoryLocations
3350 Berkmar Dr
Charlottesvle, VA 22901
Phone (434) 923-4651
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1382400000000",
"number": "1801973169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3350 BERKMAR DR",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229011491",
"telephone_number": "434-923-4651",
"fax_number": "434-964-3636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3350 BERKMAR DR",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229011491",
"telephone_number": "434-923-4651",
"fax_number": "434-964-3636"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALBEMARLE DERMATOLOGY ASSOCIATES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-01",
"last_updated": "2013-10-22",
"status": "A",
"authorized_official_last_name": "STRAKA",
"authorized_official_first_name": "BONNIE",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "OWNER/PHYSICIAN",
"authorized_official_telephone_number": "434-923-4651",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": "VA",
"license": "0101042830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlottesville, VA
- Albemarle Care Center LLC
- Albemarle Charlottesville Podiatry Associates LTD
- Albemarle Counseling Associates, PLLC
- Albemarle Counseling LLC
- Albemarle County Public Schools
- Albemarle Dynamic Psychiatry LLC
- Albemarle Endocrinology PLC
- Albemarle Family Foot & Ankle, PLLC
- Albemarle H&R Ops, LLC
- Albemarle Housing Improvement Program,Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; 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.