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Active NPI 1902292394 Individual Practitioner Male Practitioner

Dr. Blake R Zelickson , MD, PhD

Dermatology • Sterling, VA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Blake Zelickson, MD, PhD is a certified Dermatology practicing in Sterling, VA. With approximately 11 years of clinical experience since completing medical education in 2015, Dr. Zelickson delivers high-quality medical care to the local community at 22365 BRODERICK DRIVE, SUITE 115.

Dr. Zelickson is affiliated with Clear Dermatology and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, destruction of precancer skin growth, 2-14 growths, tangential biopsy of single skin lesion. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

22365 Broderick Drive, Suite 115

Sterling, VA 201669362

Telephone 1703996400
Fax 5717078123
Associated Practice Facility / Clinic
🏢 Loudoun Medical Group, Pc Facility NPI 1447747027

Medicare Profile & Education

Medical School

Other

Graduation Year

2015

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Sterling, VA

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
11 Yrs -7.0 yrs vs City Avg
City Avg: 18.0 Yrs
State Avg: 23.2 Yrs
Regional Practice Density
4 Specialists

Practicing in Sterling, VA (440 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
63.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Zelickson (11 Years) 11 Yrs
Sterling Specialty Average (18.0 Years) 18.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
178 140 $165.00 $87.49
17003 Destruction of precancer skin growth, 2-14 growths
131 21 $38.00 $6.51
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
101 73 $225.00 $124.75
11102 Tangential biopsy of single skin lesion
93 76 $275.00 $96.24
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
72 72 $265.00 $108.28
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg
72 17 $30.00 $0.96
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
34 34 $395.00 $162.57
17000 Destruction of skin growth
32 29 $184.00 $56.81
11103 Biopsy of related skin growth, each additional growth
25 18 $145.00 $48.94
17004 Destruction of precancer skin growth, 15 or more growths
21 17 $677.00 $154.99
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
19 19 $115.00 $55.12
17110 Destruction of up to 14 skin growths
16 16 $230.00 $110.95

Medical Specialties & State Licenses

CMS Verified: 2026-01-05
Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License VA 0101269123

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1902292394 (VA)
Medicaid State Provider ID
30017647860001 (VA)

Hospital & Practice Group Affiliations

Clear Dermatology

22365 Broderick Dr, Sterling, VA 201669362

Phone: 7039964000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1578774741

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

16 Historical Events
📍
Updated Business Mailing Address January 05, 2026

Registered at 22365 BRODERICK DR STE 115, STERLING, VA 201669362 (Tel: 7039964000)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 05, 2026

Dermatology (License #0101269123 in VA)

📍
Updated Practice Location July 31, 2023

Registered at 22365 BRODERICK DRIVE, SUITE 115, STERLING, VA 201669362 (Tel: 1703996400)

📍
Updated Practice Location June 16, 2020

Registered at 21785 FILIGREE CT STE 206, ASHBURN, VA 201476214 (Tel: 7039964000)

📍
Updated Business Mailing Address June 16, 2020

Registered at 224D CORNWALL ST NW STE 403, LEESBURG, VA 201762704 (Tel: 7037376001)

NPI Profile Active April 11, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location April 11, 2017

Registered at 920 MADISON AVE STE 447, UTHSC DEPT OF DERMATOLOGY, MEMPHIS, TN 381637400 (Tel: 9014481767)

📍
Updated Business Mailing Address April 11, 2017

Registered at 930 MADISON STE 840, UTHSC DEPT OF DERMATOLOGY, MEMPHIS, TN 381637400 (Tel: 9014481767)

👤
Provider Name / Credentials Updated April 11, 2017

Recorded as BLAKE ZELICKSON, M.D., PH.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 11, 2017

Dermatology (License #286353 in NY)

NPI Profile Active April 13, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location April 13, 2015

Registered at 4802 10TH AVENUE, MAIMONIDES MEDICAL CENTER, BROOKLYN, NY 11219 (Tel: 7182838000)

📍
Updated Business Mailing Address April 13, 2015

Registered at 4802 10TH AVENUE, MAIMONIDES MEDICAL CENTER, BROOKLYN, NY 11219

👤
Provider Name / Credentials Updated April 13, 2015

Recorded as BLAKE ZELICKSON, M.D., PH.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 13, 2015

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 13, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1902292394
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 13, 2015
Last Update: January 05, 2026
Sole Proprietor: Yes

Mailing Address

22365 Broderick Dr Ste 115

Sterling, VA 201669362

Phone: 7039964000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.