Individual provider Active NPI

Andy Joseph Roussel, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Lake Ridge, VA
National Provider Identifier
1417920117
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0103300955 Issued in VA
Practice address
1721 Financial Loop
Lake Ridge, VA 22192-2460
Phone
(703) 491-9500
Fax
(703) 491-9994
NPI assigned
Feb 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2012

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 0103300955 VA Primary

Addresses

Primary practice location

1721 Financial Loop
Lake Ridge, VA 22192-2460

Mailing address

1721 Financial Loop
Lake Ridge, VA 22192-2460
Phone (703) 491-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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
I20070302000394 VA Practitioner - Podiatry 5698877025 Reassigns benefits to 1 organization
I20090219000563 DC Practitioner - Podiatry 5698877025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1500 Dixon St
Suite 201
Fredericksburg, VA 22401-7231
Phone (540) 374-5261

1721 Financial Loop
Woodbridge, VA 22192-2460
Phone (703) 491-9500

2021 K St NW
Washington, DC 20006-1003
Phone (202) 223-4616

66 Pkwy LN
Suite 102
Fishersville, VA 22939-2385
Phone (540) 949-5150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.95 of 100Reported as group
Promoting interoperability
87
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue25
Removal of skin lesions11
Removal of nail tissue3227
Removal or shaving of skin growth628
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0103300955VAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Foot & Ankle Surgery CurrentSince May 1, 2021 Accepting new patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Foot & Ankle Surgery CurrentSince May 1, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2021 K St NW
Ste 520
Washington, DC 20006
Phone (202) 223-4616

10901 Connecticut Ave
Ste 200
Kensington, MD 20895
Phone (301) 949-2000

66 Parkway Ln
Ste 102
Fishersville, VA 22939
Phone (540) 949-5150

1500 Dixon St
Ste 201
Fredericksburg, VA 22401
Phone (540) 374-5261

945 Garrisonville Rd
Stafford, VA 22556
Phone (540) 720-0700

1721 Financial Loop
Woodbridge, VA 22192
Phone (703) 491-9500

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337644800000",
    "number": "1417920117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 FINANCIAL LOOP",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221922460",
            "telephone_number": "703-491-9500",
            "fax_number": "703-491-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 FINANCIAL LOOP",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221922460",
            "telephone_number": "703-491-9500",
            "fax_number": "703-491-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSEL",
        "first_name": "ANDY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-12",
        "last_updated": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103300955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ridge, VA

Sources for this page

Verify at the official NPI Registry.