Ian Michael Wattenmaker, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

0101049672 Issued in VA

Practice address

19450 Deerfield Avenue, Suite 200
Leesburg, VA 20176-6821

Phone

(703) 777-1553

Fax

(703) 777-5524

NPI assigned

Jul 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Loudoun Medical Group, PC

  • Internal Medicine Physician
  • Leesburg, VA
  • NPI 1679591440

  Orthopaedic Surgery

  Medicare reassignment NPD
• Town Center Orthopaedic Associates PC

  • Orthopaedic Surgery Physician
  • Centreville, VA
  • NPI 1407555253
  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1629077854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224D CORNWALL ST NW STE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19450 DEERFIELD AVENUE, SUITE 200",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201766821",
            "telephone_number": "703-777-1553",
            "fax_number": "703-777-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTENMAKER",
        "first_name": "IAN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101049672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30015845120002",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629077854",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawn Levine Washington, BS, NCACII, CSAC,
• Mulu Wassie
• Monica Ortensia Watkins, L.C.S.W.
• Tammala A Watkins, PH.D., L.C.S.W.
• Stephanie Watson
• Alaina Nichole Wayland
• Christine Weber, LCSW
• Michelle Reina Weddle, OTD, OTR/L, ATC
• Wegmans Food Markets, Inc. (Wegmans Pharmacy #044)
• Peter Lai Wei, M.D.

• Orthopaedic Surgery Physician in Leesburg, VA
• Providers in Leesburg, VA by specialty
• Orthopaedic Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.