Individual provider Active NPI

Michael P Cassidy, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Annandale, VA
National Provider Identifier
1588757371
Registry record updated Jul 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
0101036477 Issued in VA
Practice address
3301 Woodburn Rd #208
Annandale, VA 22003-1200
Phone
(703) 560-9495
Fax
(903) 698-7237
NPI assigned
Oct 2, 2006
Last updated
Jul 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 0101036477 VA Primary

Addresses

Primary practice location

3301 Woodburn Rd #208
Annandale, VA 22003-1200

Mailing address

3301 Woodburn Rd #208
Annandale, VA 22003-1200
Phone (703) 560-9495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110217000284 DC Practitioner - Orthopedic Surgery 3577458413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1588757371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 WOODBURN RD #208",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220031200",
            "telephone_number": "703-560-9495",
            "fax_number": "903-698-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 WOODBURN RD #208",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220031200",
            "telephone_number": "703-560-9495",
            "fax_number": "903-698-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "VA",
            "license": "0101036477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

Verify at the official NPI Registry.