Mark Edward Kozminsky, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD033463E Issued in PA

Practice address

1618 Kendra St
Charlottesville, VA 22903-7955

Phone

(814) 574-5131

NPI assigned

Oct 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Centre Dermatology PC

  • Specialist
  • State College, PA
  • NPI 1427169218
  NPD (past) Authorized official

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

{
    "created_epoch": "1129939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1861482788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 KENDRA ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229037955",
            "telephone_number": "814-574-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 KENDRA ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229037955",
            "telephone_number": "814-574-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZMINSKY",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-22",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD033463E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sreeramulu Kotakondla, MD
• Naveen Chandra Kotha, MD
• Michael John Kovac Jr., M.D.
• Curtis Kovaleski, MD
• Merrick Douglas Kozak, M.D.
• KQF Inc
• Sherry P Kraft, PH.D.
• Ellen Krag, LPC
• Jennifer L Kragie, PNP
• Andreas H. Kramer, M.D.

• Dermatology Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.