Individual provider Active NPI

Marcin Noble Vaclaw, DPM

  • Foot & Ankle Surgery Podiatrist
  • The Woodlands, TX
National Provider Identifier
1245544691
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
T36-2010 Issued in TX
Practice address
9191 Pinecroft Drive
Suite 150
The Woodlands, TX 77380-2799
Phone
(281) 909-7722
Fax
(281) 909-7733
NPI assigned
Jul 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X T36-2010 TX Primary

Addresses

Primary practice location

9191 Pinecroft Drive
Suite 150
The Woodlands, TX 77380-2799

Mailing address

9191 Pinecroft Drive
Suite 225
The Woodlands, TX 77380-2799
Phone (281) 909-7722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20131123000012 TX Practitioner - Podiatry 3779727359 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MBV PLLCGroup PAC ID 2860636446, 18 clinicians

Practice addresses (Care Compare)

9191 Pinecroft Dr
Suite 100
Shenandoah, TX 77380-2797
Phone (281) 909-7722

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue414
Removal or shaving of skin growth11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2052TXMDBehavioral Analyst
T36-2010TXMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
MBV PLLC CurrentSince Jan 31, 2013 Accepting new patients
L R Anthon DPM a Professional Corporation Foot & Ankle Surgery CurrentSince Jul 1, 2013 Accepting new patients
Fas of TW LLC Foot & Ankle Surgery CurrentSince Jan 22, 2025 Accepting new patients
MBV PLLC Foot & Ankle Surgery CurrentSince Jul 1, 2013 Accepting new patients
Doordocs, LLC Current Accepting new patients
MBV PLLC Past Accepting new patients

Locations

11511 Katy Fwy
Ste 535
Houston, TX 77079
Phone (281) 600-5000

7575 San Felipe St
Ste 301
Houston, TX 77063
Phone (346) 597-7161

640 Interstate 45 S
Huntsville, TX 77340
Phone (936) 228-3992

227 State Highway 75 N
Ste 150
Huntsville, TX 77320

9191 Pinecroft Dr
Ste 130
Shenandoah, TX 77380

9191 Pinecroft Dr
Ste 100
Shenandoah, TX 77380
Phone (866) 680-9355

9191 Pinecroft Dr
Ste 225
Shenandoah, TX 77380
Phone (281) 404-3666

9191 Pinecroft Dr
Ste 150
Shenandoah, TX 77380
Phone (281) 681-3905

434 W Ascension Way
Ste 425
Salt Lake City, UT 84123

Interoperability endpoints

  • Direct secure messaging: alleviotexas.marcinvaclaw@161097.advancedmd-direct.com
  • Direct secure messaging: drvaclaw@faasotw-tx.direct.office.nextgen.com

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1245544691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9191 PINECROFT DRIVE",
            "address_2": "SUITE 225",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773802799",
            "telephone_number": "281-909-7722",
            "fax_number": "281-909-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 PINECROFT DRIVE",
            "address_2": "SUITE 150",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773802799",
            "telephone_number": "281-909-7722",
            "fax_number": "281-909-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACLAW",
        "first_name": "MARCIN",
        "middle_name": "NOBLE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-27",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "T36-2010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.