Individual provider Active NPI

Kostadinka Hadzijska Skandeva, DPM

  • Podiatrist
  • Alexandria, VA
National Provider Identifier
1326279084
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0103301045 Issued in VA
Practice address
6151 Fuller CT
Alexandria, VA 22310-2541
Phone
(571) 480-8480
Fax
(703) 888-3909
NPI assigned
Jul 29, 2009
Last updated
Jan 25, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0103301045 VA Primary

Addresses

Primary practice location

6151 Fuller CT
Alexandria, VA 22310-2541

Mailing address

6151 Fuller CT
Alexandria, VA 22310-2541
Phone (571) 480-8480

Other identifiers 1

IdentifierTypeStateIssuer
1326279084MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120515000327 DC Practitioner - Podiatry 0941460380 Reassigns benefits to 1 organization
I20121017000942 VA Practitioner - Podiatry 0941460380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nova Foot and Ankle Center, LLCGroup PAC ID 3870753205, 2 clinicians

Practice addresses (Care Compare)

6151 Fuller Court
Alexandria, VA 22310-2541

6151 Fuller CT
Alexandria, VA 22310-2541

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue66
Removal or shaving of skin growth28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Foot & Ankle Center, LLC Podiatrist CurrentSince Mar 1, 2012 Accepting new patients

Locations

6151 Fuller Ct
Alexandria, VA 22310
Phone (571) 480-8480

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, 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": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1326279084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6151 FULLER CT",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223102541",
            "telephone_number": "571-480-8480",
            "fax_number": "703-888-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6151 FULLER CT",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223102541",
            "telephone_number": "571-480-8480",
            "fax_number": "703-888-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKANDEVA",
        "first_name": "KOSTADINKA",
        "middle_name": "HADZIJSKA",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-29",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103301045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326279084",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.