NPIMap

Organization Active NPI

Robert a Breiner PC

  • Podiatrist
  • Annandale, VA
National Provider Identifier
1245259530
Registry record updated Nov 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0103000805 Issued in VA
Legal business name
ROBERT A BREINER PC
Practice address
5105 Backlick Rd.
Suite S
Annandale, VA 22003-6005
Phone
(703) 941-7770
NPI assigned
Jul 18, 2006
Last updated
Nov 19, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2007

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

Authorized official

Name
Dr. Robert Anthony Breiner, DPMNPI 1891763447
Title
Owner
Phone
(703) 941-7770

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
Podiatrist 213E00000X 0103000805 VA Primary

Addresses

Primary practice location

5105 Backlick Rd.
Suite S
Annandale, VA 22003-6005

Mailing address

5105 Backlick Rd.
Suite S
Annandale, VA 22003-6005
Phone (703) 941-7770

Other identifiers 1

IdentifierTypeStateIssuer
9301615MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20070126000115 DC Part B Supplier - Clinic/Group Practice 1153322664 Receives reassigned benefits from 3 practitioners
Practice locations: Annadale, VA
O20100624000775 VA Part B Supplier - Clinic/Group Practice 1153322664 Receives reassigned benefits from 1 practitioner
Practice locations: Annandale, VA
O20100930056613 VA DME Supplier - Physician - Podiatry 1153322664 Practice locations: Annandale, VA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21432/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1245259530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 BACKLICK RD.",
            "address_2": "SUITE S",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220036005",
            "telephone_number": "703-941-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5105 BACKLICK RD.",
            "address_2": "SUITE S",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220036005",
            "telephone_number": "703-941-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A BREINER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "BREINER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-941-7770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103000805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9301615",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; 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.