Individual provider Active NPI

Rhonda Nelson, DPM

  • Podiatrist
  • Glenn Dale, MD
National Provider Identifier
1083603427
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
01318 Issued in MD
Practice address
12150 Annapolis Road
Suite 109
Glenn Dale, MD 20769-9183
Phone
(301) 773-1199
Fax
(301) 773-1198
NPI assigned
Oct 18, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 01318 MD Primary

Addresses

Primary practice location

12150 Annapolis Road
Suite 109
Glenn Dale, MD 20769-9183

Mailing address

12150 Annapolis Road
Suite 109
Glenn Dale, MD 20769-9183
Phone (301) 773-1199

Other identifiers 2

IdentifierTypeStateIssuer
134103100MedicaidMD
P00380750OtherMDPALMETTO GBA -RAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040305000066 DC Practitioner - Podiatry 9739077439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12150 Annapolis Rd
Suite 109
Glenn Dale, MD 20769-9183
Phone (301) 352-3668

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue194
Removal or shaving of skin growth66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Podiatry Care Center, LLC Podiatrist CurrentSince Jan 1, 2001 Accepting new patients
Oliver Foster DPM a Professional Corp PastSince Mar 8, 2010 Accepting new patients
Maryland Cardiology Associates, LLC PastSince Jan 1, 2001 Accepting new patients
Mario a. Pacada, DPM, Inc Podiatrist Past Accepting new patients

Locations

12150 Annapolis Rd
Ste 109
Glenn Dale, MD 20769
Phone (301) 352-3668

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1083603427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12150 ANNAPOLIS ROAD",
            "address_2": "SUITE 109",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699183",
            "telephone_number": "301-773-1199",
            "fax_number": "301-773-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 ANNAPOLIS ROAD",
            "address_2": "SUITE 109",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699183",
            "telephone_number": "301-773-1199",
            "fax_number": "301-773-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "RHONDA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "01318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134103100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA -RAILROAD MEDICARE",
            "identifier": "P00380750",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenn Dale, MD

Sources for this page

Verify at the official NPI Registry.