NPIMap

Organization Active NPI

Foot and Ankle Pain Center LLC

  • Durable Medical Equipment & Medical Supplies
  • Columbia, MD
National Provider Identifier
1538773767
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
FOOT AND ANKLE PAIN CENTER LLC
Practice address
9821 Broken Land Pkwy Ste 103
Columbia, MD 21046-1161
Phone
(410) 575-3668
NPI assigned
Sep 4, 2020
Last updated
Sep 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Authorized official

Name
Dr. Benjamin David Elgamil, DPMNPI 1831539303
Title
Owner
Phone
(410) 575-3668

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
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

9821 Broken Land Pkwy Ste 103
Columbia, MD 21046-1161

Mailing address

9821 Broken Land Pkwy Ste 103
Columbia, MD 21046-1161
Phone (410) 575-3668

Other names 1

  • FAPC Medical Supplies Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210219000606 MD DME Supplier - Physician - PodiatryDME Supplier - Ambulatory Surgical Center 4688093347 Practice locations: Columbia, MD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Foot and Ankle Pain Center LLC9821 Broken Land Pkwy, Columbia, MD 21046-1161(410) 575-3668 Contracture Treatment Devices: Dynamic Splint|Heat & Cold Applications|Negative Pressure Wound Therapy Pumps/Supplies|Osteogenesis Stimulators|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Canes and/or Crutches|Walkers|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Cu… Accepts assignmentParticipating since Sep 1, 2020

National Provider Directory

National Provider Directory
Tax ID family
Foot and Ankle Pain Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

9821 Broken Land Pkwy
Ste 103
Columbia, MD 21046
Phone (410) 575-3668

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": "1599177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599177600000",
    "number": "1538773767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9821 BROKEN LAND PKWY STE 103",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461161",
            "telephone_number": "410-575-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9821 BROKEN LAND PKWY STE 103",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461161",
            "telephone_number": "410-575-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE PAIN CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A",
        "authorized_official_last_name": "ELGAMIL",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-575-3668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAPC Medical Supplies",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.