Individual provider Active NPI

William Dubiel, DPT

  • Physical Therapist
  • Herndon, VA
National Provider Identifier
1407480478
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305213442 Issued in VA
Practice address
13039 Worldgate Dr
Herndon, VA 20170-4374
Phone
(703) 689-3164
Fax
(703) 689-3167
NPI assigned
Feb 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305213442 VA Primary

Addresses

Primary practice location

13039 Worldgate Dr
Herndon, VA 20170-4374

Mailing address

PO Box 1769
Middleburg, VA 20118-1769
Phone (703) 689-3164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200408003074 VA Practitioner - Physical Therapist in Private Practice 9032547120 Reassigns benefits to 1 organization
I20201201000917 NC Practitioner - Physical Therapist in Private Practice 9032547120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Mercy College, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Specialists of North Carolina, P.a.Group PAC ID 7810974375, 49 clinicians

Practice addresses (Care Compare)

1936 Golden Spur LN
Wendell, NC 27591-3305
Phone 91956294103305

Merit-based Incentive Payment System (MIPS)

Final score
83.06 of 100Reported as group
Quality
61.01
Promoting interoperability
100
Improvement activities
40
Cost
82.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305213442VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Specialists of North Carolina, P.a. Physical Therapist CurrentSince Nov 2, 2020 Accepting new patients
Orthopaedic Specialists of North Carolina, P.a. CurrentSince Nov 2, 2020 Accepting new patients
The Jackson Clinics LLC Physical Therapist PastSince Mar 23, 2020 Accepting new patients

Locations

6602 Knightdale Blvd
Ste 310
Knightdale, NC 27545

5838 Six Forks Rd
Ste 300
Raleigh, NC 27609
Phone (919) 782-5954

11200 Governor Manly Way
Ste 309
Raleigh, NC 27614
Phone 9195629410247

1936 Golden Spur Ln
Wendell, NC 27591

Interoperability endpoints

  • Direct secure messaging: william.dubiel.1@12529.direct.athenahealth.com

Organizations & group practices 4

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": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1407480478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1769",
            "city": "MIDDLEBURG",
            "state": "VA",
            "postal_code": "201181769",
            "telephone_number": "703-689-3164",
            "fax_number": "703-689-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13039 WORLDGATE DR",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704374",
            "telephone_number": "703-689-3164",
            "fax_number": "703-689-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBIEL",
        "first_name": "WILLIAM",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305213442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.