Individual provider Active NPI

Bruce Ira Vogel, DPM

  • Podiatrist
  • Manassas, VA
National Provider Identifier
1295700144
Registry record updated Nov 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0103000297 Issued in VA
Practice address
8577 Sudley Rd
Manassas, VA 20110-3860
Phone
(703) 368-7166
Fax
(703) 368-5103
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0103000297 VA Primary

Addresses

Primary practice location

8577 Sudley Rd
Manassas, VA 20110-3860

Mailing address

8577 Sudley Rd
Manassas, VA 20110-3860
Phone (703) 368-7166

Other identifiers 11

IdentifierTypeStateIssuer
35564OtherUNITED HEALTH CARE
A8890003OtherCAREFIRST BCBS
010300297OtherUNITED HEALTHCARE
35564OtherMAMSI
480000291OtherMEDICARE TRAILBLAZERS
CC5940OtherVARAILROAD MEDICARE GROUP
4800113111OtherRAILROAD MEDICARE
0442570002OtherDMERC
543846OtherAETNA
090283OtherANTHEM BCBS
9331476MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Podiatrist Current Accepting new patients

Locations

11737 Bowman Green Dr
Reston, VA 20190
Phone (703) 437-6333

Organizations & group practices 1

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257120000000",
    "number": "1295700144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8577 SUDLEY RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201103860",
            "telephone_number": "703-368-7166",
            "fax_number": "703-368-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8577 SUDLEY RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201103860",
            "telephone_number": "703-368-7166",
            "fax_number": "703-368-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOGEL",
        "first_name": "BRUCE",
        "middle_name": "IRA",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2009-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103000297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "35564",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "A8890003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "010300297",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "35564",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TRAILBLAZERS",
            "identifier": "480000291",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CC5940",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "4800113111",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0442570002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "543846",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "090283",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9331476",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.