NPIMap

Organization Active NPI

Foot and Ankle Specialists of the Mid-Atlantic, LLC

Doing business as Lakeforest Foot and Ankle

  • Podiatrist
  • Gaithersburg, MD
National Provider Identifier
1659026011
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
FOOT AND ANKLE SPECIALISTS OF THE MID-ATLANTIC, LLC
Doing business as
Lakeforest Foot and Ankle
Practice address
702 Russell Ave Ste 103
Gaithersburg, MD 20877-2606
Phone
(301) 948-3668
NPI assigned
Feb 15, 2022
Last updated
Feb 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Authorized official

Name
Michael Tritto, MD
Title
Authorized Offical
Phone
(301) 933-7133

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

702 Russell Ave Ste 103
Gaithersburg, MD 20877-2606

Mailing address

PO Box 825159
Philadelphia, PA 19182-5159
Phone (301) 933-7133

Other names 1

  • Lakeforest Foot and Ankle Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230317002692 MD DME Supplier - Physician - Podiatry 6305017633 Practice locations: Gaithersburg, MD

National Provider Directory

National Provider Directory
Tax ID family
Foot and Ankle Specialists of the Mid Atlantic LLC98 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Locations

702 Russell Ave
Ste 103
Gaithersburg, MD 20877
Phone (301) 736-6900

NPI Registry JSON

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

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1659026011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825159",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191825159",
            "telephone_number": "301-933-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 RUSSELL AVE STE 103",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772606",
            "telephone_number": "301-948-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE SPECIALISTS OF THE MID-ATLANTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-15",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A",
        "authorized_official_last_name": "TRITTO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICAL",
        "authorized_official_telephone_number": "301-933-7133",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeforest Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lakeforest Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.