COMMONWEALTH DERMATOLOGY, PC – Dermatology Physician, NPI 1013091115

COMMONWEALTH DERMATOLOGY, PC is a healthcare provider. based in Richmond, Virginia. specializing in Dermatology Physician. The organization holds a License No. 0101233942 (VA). The NPI Number for COMMONWEALTH DERMATOLOGY, PC is 1013091115

Main info

Organization
Name
COMMONWEALTH DERMATOLOGY, PC
NPI
1013091115
Phone
(804) 282-0831
Address
7001 FOREST AVE
Authorized Official
HAZLE KONERDING PRESIDENT MD
Enumeration Date
25 October 2006
Last Update Date
3 September 2014
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience78
Completeness75
Years active:19State licenses:7Digital endpointsOther names

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Provider Addresses for COMMONWEALTH DERMATOLOGY, PC

  • Forest Avenue, Richmond, Madison County, Kentucky, 40475, United States

    STE. 400

    RICHMOND, VA 232301726

    Phone: (804) 282-0831

    Fax: (804) 288-7135

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-12-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20041206001202OClinic/Group PracticeVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 23230)

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Reviews

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Frequently asked questions

How do I look up COMMONWEALTH DERMATOLOGY, PC by NPI?
Use NPI 1013091115 when you need to reference COMMONWEALTH DERMATOLOGY, PC in forms, claims, or directories.
Is COMMONWEALTH DERMATOLOGY, PC active in the national directory?
COMMONWEALTH DERMATOLOGY, PC's public NPI profile is in an active state.
What kind of provider is COMMONWEALTH DERMATOLOGY, PC?
The page reflects Dermatology Physician for COMMONWEALTH DERMATOLOGY, PC. Clinical services aligned with this taxonomy classification.
What location metadata exists for COMMONWEALTH DERMATOLOGY, PC?
The page summarizes Richmond, Virginia for COMMONWEALTH DERMATOLOGY, PC; expand the address list for detail.
What if Richmond, Virginia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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