INTEGRATED DERMATOLOGY OF FAIRFAX, LLC
NPI 1861890303
Dermatology in Fairfax, VA
About Integrated Dermatology Of Fairfax, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INTEGRATED DERMATOLOGY OF FAIRFAX, LLC (NPI 1861890303) is a healthcare organization registered as a dermatology in Fairfax, Virginia and active in the NPI registry since December 2014. The organization holds a CLIA Certificate of Compliance certificate valid through February 27, 2027 and lists Jeffrey D. Queen, Authorized Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Integrated Dermatology Of Fairfax, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Integrated Dermatology Of Fairfax, LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Compliance 49D0221779
Integrated Dermatology Of Fairfax, LLC · Fairfax, VAFrequently 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 Integrated Dermatology Of Fairfax, LLC's NPI number?
The NPI number for Integrated Dermatology Of Fairfax, LLC is 1861890303. It was assigned to this organization in the NPPES registry on December 16, 2014.
Where is Integrated Dermatology Of Fairfax, LLC located?
Integrated Dermatology Of Fairfax, LLC is located at 10680 Main St Ste 200, Fairfax, VA 22030. The listed phone number is (703) 352-2620.
What is Integrated Dermatology Of Fairfax, LLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Integrated Dermatology Of Fairfax, LLC enrolled in Medicare?
Yes. Integrated Dermatology Of Fairfax, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Integrated Dermatology Of Fairfax, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Integrated Dermatology Of Fairfax, LLC. A 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 the clinician's services. The largest specialties are Dermatology (4) and Micrographic Dermatologic Surgery (MDS) (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Integrated Dermatology Of Fairfax, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 49D0221779) is associated with this NPI, valid through February 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Integrated Dermatology Of Fairfax, LLC was last updated on February 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Integrated Dermatology Of Fairfax, Llc · NPI 1861890303
Dermatology organization in Fairfax, Virginia. Organization record, active in the CMS NPPES registry since December 16, 2014.
## Identity
- **NPI:** 1861890303 (Entity type: Organization)
- **Enumerated:** December 16, 2014
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Jeffrey Queen, AUTHORIZED OFFICIAL
## Practice location
- **Address:** 10680 MAIN ST STE 200, Fairfax, VA 22030-3810
- **Phone:** (703) 352-2620
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (4), Micrographic Dermatologic Surgery (MDS) (1); 4 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 21, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1861890303) · Data from the CMS NPPES public registry.