Healthdrive Podiatry Group, PC
Organization Active NPI Podiatrist · Columbia, MD
NPI 1548685258 · NPPES record last updated Nov 1, 2020
Key facts
- NPI
- 1548685258
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Podiatrist 213E00000X
- Legal business name
- HEALTHDRIVE PODIATRY GROUP, PC
- Practice address
- 6700 Alexander Bell Dr
Suite 200
Columbia, MD 21046-2122 - Phone
- (888) 964-6681
- Fax
- (888) 662-0859
- NPI assigned
- Mar 4, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Shadi Adib Abboud, DPM
- Title
- Treasurer/Practice Director
- Phone
- (857) 255-0486
Owned or controlled facilities with NPI records 1
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 8
Corporate family (same tax ID) 9
Practitioners 109
-
Amenze Ehanika, DPM
-
Teresa Leah Hilliard, DPM
-
Tanno Kaur, DPM
-
Jennifer Ann Lipman, D.P.M.
-
Manish Singh Pabla, D.P.M.
-
Riya Altomonte, DPM
-
Rodney L. Bland, DPM
-
Jeremy William Brouillette, D.P.M.
-
Stephanie Ann Crone, DPM
-
Meng Liu, DPM
-
Nilufar Medhane, DPM
-
Brian Samuel Kressin, DPM
-
Rikhil D Patel, D.P.M.
-
Lennie Michele Peters, D.P.M.
-
Shadi Adib Abboud, DPM
-
Edward Paul Abegg, D.P.M.
-
Jamey Ann Allen, DPM
-
Joseph David Arbanas, D.P.M.
-
Magdalene Armanious, DPM
-
Bruce M Backer, D.P.M.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MD, DC, VA
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Morristown Manor |
Skilled nursing facility | Adp of the SNF | Mar 7, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140805001308 | MD | Part B Supplier - Clinic/Group Practice | 3375446958 |
Receives reassigned benefits from 10 practitioners Practice locations: Columbia, MD |
| O20160412000208 | DC | Part B Supplier - Clinic/Group Practice | 3375446958 |
Receives reassigned benefits from 18 practitioners Practice locations: Alexandria, VA; Takoma Park, MD |
| O20201105000851 | VA | Part B Supplier - Clinic/Group Practice | 3375446958 |
Receives reassigned benefits from 7 practitioners 1 other NPI on this enrollment Practice locations: Hampton, VA |
National Provider Directory
- Tax ID family
- Healthdrive Podiatry GRP PC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist |
213E00000X | Yes |
Addresses
Primary practice location
6700 Alexander Bell Dr
Suite 200
Columbia, MD 21046-2122
Mailing address
100 Crossing Blvd
Suite 300
Framingham, MA 01702-5555
Phone (617) 964-6681
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 562902100 | Medicaid | MD |
Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.