Individual provider Active NPI

Mitchell R Waskin, DPM

  • Foot Surgery Podiatrist
  • Richmond, VA
National Provider Identifier
1528052115
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
0103000676 Issued in VA
Practice address
1465 Johnston Willis Dr
Richmond, VA 23235-4730
Phone
(804) 320-3668
Fax
(804) 320-2600
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 0103000676 VA Primary

Addresses

Primary practice location

1465 Johnston Willis Dr
Richmond, VA 23235-4730

Mailing address

1465 Johnston Willis Dr
Richmond, VA 23235-4730
Phone (804) 320-3668

Other identifiers 1

IdentifierTypeStateIssuer
010103720MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20041119000135 VA Practitioner - Podiatry 9133116866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot and Ankle Specialists of the Mid-Atlantic LLCGroup PAC ID 6305017633, 157 clinicians
Professional Therapies of Roanoke, Inc.Group PAC ID 3375710619, shared by 5 NPIs, 272 clinicians

Practice addresses (Care Compare)

1465 Johnston Willis Dr
North Chesterfield, VA 23235-4730
Phone (804) 320-3668

6800 Woodlake Commons Loop
Midlothian, VA 23112-2281
Phone (804) 302-4589

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 tissue15
Removal of skin lesions1-10
Removal of nail tissue370
Removal or shaving of skin growth61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC CurrentSince Oct 1, 2017 Accepting new patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC CurrentSince Oct 1, 2017 Accepting new patients
Foot and Ankle Specialists of Virginia PC Foot Surgery Past Accepting new patients

Locations

1600 E Gude Dr
Ste 200
Rockville, MD 20850

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

1465 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 320-3668

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.

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1528052115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 JOHNSTON WILLIS DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232354730",
            "telephone_number": "804-320-3668",
            "fax_number": "804-320-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 JOHNSTON WILLIS DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232354730",
            "telephone_number": "804-320-3668",
            "fax_number": "804-320-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASKIN",
        "first_name": "MITCHELL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "VA",
            "license": "0103000676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010103720",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.