NPIMap

Organization Active NPI

Potomac Podiatry PLLC

  • Foot & Ankle Surgery Podiatrist
  • Woodbridge, VA
National Provider Identifier
1184731549
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0103000852 Issued in VA
Legal business name
POTOMAC PODIATRY PLLC
Practice address
14010 Smoketown Rd Ste 103
Woodbridge, VA 22192-4723
Phone
(703) 583-5959
Fax
(703) 583-5995
NPI assigned
Aug 23, 2006
Last updated
Jul 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Authorized official

Name
Dr. Vincent Joseph Bonini, DPMNPI 1790892131
Title
President
Phone
(703) 583-5959

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0103000852 VA Primary

Addresses

Primary practice location

14010 Smoketown Rd Ste 103
Woodbridge, VA 22192-4723

Mailing address

14010 Smoketown Rd Ste 103
Woodbridge, VA 22192-4723
Phone (703) 583-5959

Other practice location 1

1657 Crofton Blvd Ste 201
Crofton, MD 21114-1348
Phone (410) 721-4505

Other practice location 2

46440 Benedict Dr Ste 209
Sterling, VA 20164-6602
Phone (703) 583-5959

Other practice location 3

4475 Regency Pl Ste 204
White Plains, MD 20695-3074
Phone (301) 645-1406

Other practice location 4

43 Old Solomons Island Rd Ste 102
Annapolis, MD 21401-3851
Phone (410) 263-3100

Other identifiers 2

IdentifierTypeStateIssuer
3001524257MedicaidVA
8890421MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, MD4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20051104000617 DC Part B Supplier - Clinic/Group Practice 8527086834 Receives reassigned benefits from 8 practitioners
Practice locations: Chantilly, VA; Fairfax, VA; Falls Church, VA
O20051202000466 VA Part B Supplier - Clinic/Group Practice 8527086834 Receives reassigned benefits from 8 practitioners
Practice locations: Woodbridge, VA; Sterling, VA
O20100930070437 VA DME Supplier - Physician - Podiatry 8527086834 Practice locations: Woodbridge, VA
O20210426000484 MD Part B Supplier - Clinic/Group Practice 8527086834 Receives reassigned benefits from 5 practitioners
Practice locations: Annapolis, MD; Crofton, MD; White Plains, MD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Potomac Podiatry PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

43 Old Solomons Island Rd
Ste 102
Annapolis, MD 21401
Phone (410) 263-3100

1657 Crofton Blvd
Ste 201
Crofton, MD 21114
Phone (410) 721-4505

46440 Benedict Dr
Ste 209
Sterling, VA 20164
Phone (703) 408-0816

2280 Opitz Blvd
#2230
Woodbridge, VA 22191
Phone (703) 583-5959

2280 Opitz Blvd
Ste 230
Woodbridge, VA 22191
Phone (703) 583-5929

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1184731549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14010 SMOKETOWN RD STE 103",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924723",
            "telephone_number": "703-583-5959",
            "fax_number": "703-583-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14010 SMOKETOWN RD STE 103",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924723",
            "telephone_number": "703-583-5959",
            "fax_number": "703-583-5995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1657 Crofton Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Crofton",
            "state": "MD",
            "postal_code": "211141348",
            "country_code": "US",
            "telephone_number": "410-721-4505",
            "fax_number": "410-721-2394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "46440 Benedict Dr Ste 209",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201646602",
            "country_code": "US",
            "telephone_number": "703-583-5959",
            "fax_number": "703-583-5995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4475 Regency Pl Ste 204",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "MD",
            "postal_code": "206953074",
            "country_code": "US",
            "telephone_number": "301-645-1406",
            "fax_number": "301-645-0997",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "43 Old Solomons Island Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MD",
            "postal_code": "214013851",
            "country_code": "US",
            "telephone_number": "410-263-3100",
            "fax_number": "410-263-7380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "POTOMAC PODIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A",
        "authorized_official_last_name": "BONINI",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-583-5959",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103000852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3001524257",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8890421",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.