THE SKINSTITUTE – Dermatology Physician, NPI 1396973053
Dermatology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for THE SKINSTITUTE
19465 DEERFIELD AVE STE 201
LEESBURG, VA 201761703
Phone: (703) 914-3603
Type: Mailing
11801 FOREST HEIGHTS CT
HERNDON, VA 201702408
Phone: (703) 450-0040
Type: Mailing
Allergy Asthma & Immunology Institute: Laura Ispas-Ponas, MD, 19455, Deerfield Avenue, Lansdowne Woods of Virginia, Lansdowne, Loudoun County, Virginia, 20176, United States
SUITE 311
LANSDOWNE, VA 201768100
Phone: (703) 723-9741
Type: Location
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: 2023-03-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-09-30 (253 days ago).
Enrollment records
2
Earliest due date
2025-09-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20090821000222 | O | Clinic/Group Practice | VA | 2025-09-30 |
| O20230322002120 | O | Clinic/Group Practice | VA | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
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 20176)
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