NPIMap

Organization Active NPI

Potomac Podiatry PLLC

  • Foot & Ankle Surgery Podiatrist
  • White Plains, MD
National Provider Identifier
1427761600
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
POTOMAC PODIATRY PLLC
Practice address
4475 Regency PL Ste 204
White Plains, MD 20695-3074
Phone
(301) 645-1406
NPI assigned
Jan 3, 2023
Organization subpart
Yes
Parent organization
POTOMAC PODIATRY GROUP PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Authorized official

Name
Vincent Joseph Bonini, DPMNPI 1790892131
Title
Owner
Phone
(703) 583-5959

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 & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

4475 Regency PL Ste 204
White Plains, MD 20695-3074

Mailing address

14010 Smoketown Rd Ste 103
Woodbridge, VA 22192-4723
Phone (703) 583-5959

National Provider Directory

National Provider Directory
Tax ID family
Potomac Podiatry PLLC4 organizations share this tax ID, including this one
Part of
Potomac Podiatry PLLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1672704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672704000000",
    "number": "1427761600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14010 SMOKETOWN RD STE 103",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924723",
            "telephone_number": "703-583-5959",
            "fax_number": "703-583-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 REGENCY PL STE 204",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953074",
            "telephone_number": "301-645-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC PODIATRY PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POTOMAC PODIATRY GROUP PLLC",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A",
        "authorized_official_last_name": "BONINI",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-583-5959",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.