NPIMap

Organization Active NPI

Nova Foot & Ankle Center, LLC

  • Foot Surgery Podiatrist
  • Alexandria, VA
National Provider Identifier
1417221219
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
0103301045 Issued in VA
Legal business name
NOVA FOOT & ANKLE CENTER, LLC
Practice address
6151 Fuller CT
Alexandria, VA 22310-2541
Phone
(571) 480-8480
Fax
(703) 888-3909
NPI assigned
Feb 27, 2012
Last updated
Feb 20, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Authorized official

Name
Kostadinka Hadzijska Skandeva, DPMNPI 1326279084
Title
Owner
Phone
(571) 480-8480

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
Foot Surgery Podiatrist 213ES0131X 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 2

IdentifierTypeStateIssuer
1326279084MedicaidVA
6683570001OtherVAMEDICARE DME PTAN

Medicare participation

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

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20120515000300 DC Part B Supplier - Clinic/Group Practice 3870753205 Receives reassigned benefits from 2 practitioners
Practice locations: Alexandria, VA
O20120529000507 VA DME Supplier - Physician - Podiatry 3870753205 Practice locations: Alexandria, VA
O20121017000934 VA Part B Supplier - Clinic/Group Practice 3870753205 Receives reassigned benefits from 2 practitioners
Practice locations: Alexandria, VA

National Provider Directory

National Provider Directory

Locations

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

7007 Backlick Ct
Ste 100
Springfield, VA 22151

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": "1330300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361318400000",
    "number": "1417221219",
    "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": {
        "organization_name": "NOVA FOOT & ANKLE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-27",
        "last_updated": "2013-02-20",
        "status": "A",
        "authorized_official_last_name": "SKANDEVA",
        "authorized_official_first_name": "KOSTADINKA",
        "authorized_official_middle_name": "HADZIJSKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-480-8480",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "VA",
            "license": "0103301045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326279084",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME PTAN",
            "identifier": "6683570001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; 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.