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KASANDRA RAE DASSOULAS
NPI 1063702223
Plastic Surgery in Kensington, MD

Active since April 08, 2011PECOS EnrolledAccepts Medicare Assignment
10810 CONNECTICUT AVE, KENSINGTON, MD 20895(434) 326-7386 Get Directions Write a Review

NPPES record last updated: June 21, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 21, 2021, Aug 24, 2018, Mar 17, 2018 (3 updates tracked since 2018).

About Kasandra Rae Dassoulas NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KASANDRA RAE DASSOULAS (NPI 1063702223) is an individual plastic surgery provider in Kensington, Maryland, licensed in Maryland (D83761) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of University Of Virginia School Of Medicine (2011).

NPPES Registry Identity

NPI1063702223
Entity TypeIndividualFemale
Primary Taxonomy208200000X
Provider Legal NameKASANDRA RAE DASSOULAS
Location Address10810 CONNECTICUT AVEKensington, MD 20895-2138
Mailing Address10810 Connecticut AveKensington, MD 20895-2138 · (301) 929-7100
Phone(434) 326-7386
Sole ProprietorNo
Medical School CMSUniversity Of Virginia School Of MedicineGraduated 2011
Enumeration DateApril 8, 2011
Last NPPES UpdateJune 21, 20213 updates tracked since enumeration
NPPES CertifiedJune 17, 2021
✔ NPI 1063702223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in MD · D83761
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
10810 CONNECTICUT AVE, Kensington, MD 20895
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Secondary Practice Locations 3

Location 11215 Lee St, Box 800376Charlottesville, VA 22908-0136 · Phone (434) 924-1234 · Fax (434) 924-1333
Location 2227 St. Paul Place, 6TH FloorBaltimore, MD 21202 · Phone (410) 332-9700
Location 311934 W Broad St Ste 200Richmond, VA 23233 · Phone (804) 424-2000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kasandra Rae Dassoulas is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810126844
PECOS Enrollment IDI20180206001292, I20190403001470
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kasandra Dassoulas reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc
Same address
Ambulatory Surgical
10810 CONNECTICUT AVE
Kensington, MD 20895
NPI 1578638425 (301) 929-7275

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20895 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BEVERLY HAGNER DARNELL MD
Internal Medicine
10810 CONNECTICUT AVE
KENSINGTON, MD 20895
Montgomery County (301) 929-7100
DR. TIMOTHY DONALD SWARTZ DPM
Podiatrist (Foot & Ankle Surgery)
10810 CONNECTICUT AVE, KENSINGTON MEDICAL CENTER
KENSINGTON, MD 20895
Montgomery County (301) 929-7100
DR. STEVEN G CHATLIN DPM
Podiatrist
10810 CONNECTICUT AVE, KAISER PERMANENTE KENSINGTON MEDICAL CENTER
KENSINGTON, MD 20895
Montgomery County (301) 929-7100
MARGARITA LITVAK-KELNER MD
Obstetrics & Gynecology
10810 CONNECTICUT AVE
KENSINGTON, MD 20895
Montgomery County (301) 929-7100
SUMMER R HERLIHY M.D.
Radiology (Diagnostic Radiology)
10810 CONNECTICUT AVE
KENSINGTON, MD 20895
Montgomery County (202) 853-1155
DR. ALICE LEE PHARMD
Pharmacist
10810 CONNECTICUT AVE
KENSINGTON, MD 20895
Montgomery County (301) 929-7100
JONATHAN DE SHIELDS MD
Internal Medicine
10810 CONNECTICUT AVE
KENSINGTON, MD 20895
Montgomery County (301) 297-1003
RONJEET K REDDY MD
Pain Medicine (Interventional Pain Medicine)
10810 CONNECTICUT AVE
KENSINGTON, MD 20895
Montgomery County (301) 929-7100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kasandra Dassoulas's NPI number?

The NPI number for Kasandra Dassoulas is 1063702223. It was assigned to this individual provider in the NPPES registry on April 8, 2011.

Where is Kasandra Dassoulas located?

Kasandra Dassoulas practices at 10810 Connecticut Ave, Kensington, MD 20895. The listed phone number is (434) 326-7386.

What is Kasandra Dassoulas's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Kasandra Dassoulas enrolled in Medicare?

Yes. Kasandra Dassoulas is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kasandra Dassoulas's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kasandra Dassoulas reassigns Medicare benefits to Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc (Kensington, MD). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kasandra Dassoulas's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kasandra Dassoulas was last updated on June 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.