Active NPI
Arnela Zukanovic
- Dermatology Physician
- Reston, VA
National Provider Identifier
1912464595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 0110006557
- Practice address
- 1800 Town Center Dr Ste 212
Reston, VA 20190-3238 - Phone
- (703) 766-2220
- NPI assigned
- Mar 1, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 0110006557 | VA | Primary |
| Physician Assistant | 363A00000X | 0110006557 | VA |
Addresses
Primary practice location
1800 Town Center Dr Ste 212
Reston, VA 20190-3238
Mailing address
1800 Town Center Dr Ste 212
Reston, VA 20190-3238
Phone (703) 766-2220
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1800 Town Ctr Dr
Suite 212
Reston, VA 20190-3238
Phone (703) 766-2220
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110006557 | VA | MD | Dermatology Physician |
Interoperability endpoints
- azukanovic@directaddress.net
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600819200000",
"number": "1912464595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 TOWN CENTER DR STE 212",
"city": "RESTON",
"state": "VA",
"postal_code": "201903238",
"telephone_number": "703-766-2220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 TOWN CENTER DR STE 212",
"city": "RESTON",
"state": "VA",
"postal_code": "201903238",
"telephone_number": "703-766-2220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZUKANOVIC",
"first_name": "ARNELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-01",
"last_updated": "2020-09-23",
"certification_date": "2020-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "VA",
"license": "0110006557",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110006557",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.