Integrated Dermatology of Fairfax, LLC
NPI 1861890303ActiveOrganization· Dermatology· Fairfax, VA
Dermatology in Fairfax, Virginia, registered in NPPES in December 2014. The authorized official on file is Jeffrey D. Queen, Authorized Official. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1861890303 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 16, 2014 |
| Last updated in NPPES | Feb 21, 2024 |
| Certified by provider | Feb 21, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (DC) |
|---|
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