Individual provider Active NPI

Mary Clare Zavada, D.P.M.

  • Podiatrist
  • Crofton, MD
National Provider Identifier
1659619732
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
2016014657 Issued in MO
Practice address
1475 Jordan Ave
Crofton, MD 21114-2119
Phone
(443) 852-4453
NPI assigned
Jan 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 2016014657 MO Primary
Foot & Ankle Surgery Podiatrist 213ES0103X SC006425 PA
Foot & Ankle Surgery Podiatrist 213ES0103X 01546 MD

Addresses

Primary practice location

1475 Jordan Ave
Crofton, MD 21114-2119

Mailing address

1475 Jordan Ave
Crofton, MD 21114-2119
Phone (443) 852-4453

Other identifiers 2

IdentifierTypeStateIssuer
P01725317OtherMORAILROAD MEDICARE
1659619732MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140729002519 MD Practitioner - Podiatry 8022234970 Reassigns benefits to 2 organizations
I20201230002719 DC Practitioner - Podiatry 8022234970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14201 Park Ctr Dr
Laurel, MD 20707-5251

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.51 of 100Reported as group
Quality
90
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue824
Removal or shaving of skin growth91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC006425PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Hertz and Idol DPM, PA Podiatrist CurrentSince May 1, 2022 Accepting new patients
Precision Orthopedics and Sports Medicine Current Accepting new patients
Precision Orthopedics and Sports Medicine CurrentSince Jan 1, 2025 Accepting new patients
Precision Orthopedics and Sports Medicine Foot & Ankle Surgery CurrentSince Jan 1, 2025 Accepting new patients
Precision Orthopedics and Sports Medicine CurrentSince Jan 1, 2025 Accepting new patients
Up Orthopedics LLC Past Accepting new patients

Locations

3169 Braverton St
Edgewater, MD 21037
Phone (410) 956-1101

8115 Maple Lawn Blvd
Ste 220
Fulton, MD 20759
Phone (301) 298-5334

1430 Solomons Island Rd
Huntingtown, MD 20639
Phone (301) 884-6056

6700 Crain Hwy
Ste 101
La Plata, MD 20646
Phone (240) 685-2925

16 N La Plata Ct
La Plata, MD 20646
Phone (301) 392-3330

5 N La Plata Ct
Ste 203
La Plata, MD 20646
Phone (240) 307-4700

14201 Park Center Dr
Ste 410
Laurel, MD 20707
Phone (301) 298-5334

22335 Exploration Dr
Ste 1015
Lexington Park, MD 20653
Phone (301) 863-6601

12090 Old Line Ctr
Ste R10A
Waldorf, MD 20602
Phone (301) 498-0333

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1659619732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 JORDAN AVE",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142119",
            "telephone_number": "443-852-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 JORDAN AVE",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142119",
            "telephone_number": "443-852-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAVADA",
        "first_name": "MARY CLARE",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-23",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MO",
            "license": "2016014657",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006425",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": "01546",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01725317",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659619732",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

Verify at the official NPI Registry.