Individual provider Active NPI

Ivan Rubiano, DPM

  • Foot & Ankle Surgery Podiatrist
  • Roanoke, VA
National Provider Identifier
1689020703
Registry record updated May 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0103301173 Issued in VA
Practice address
222 Walnut Ave SW
Roanoke, VA 24016-4723
Phone
(540) 344-3668
NPI assigned
May 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0103301173 VA Primary
Foot & Ankle Surgery Podiatrist 213ES0103X PO3780 FL

Addresses

Primary practice location

222 Walnut Ave SW
Roanoke, VA 24016-4723

Mailing address

222 Walnut Ave SW
Roanoke, VA 24016-4723

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160920002406 VA Practitioner - Podiatry 0547557431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Dudley St
Martinsville, VA 24112-1905
Phone (540) 344-3668

1802 Braeburn Dr
Suite A2130
Salem, VA 24153-7357
Phone (540) 344-3668

222 Walnut Ave SW
Roanoke, VA 24016-4723
Phone (540) 344-3668

66 Pkwy LN
Suite 102
Fishersville, VA 22939-2385
Phone (540) 949-5150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.95 of 100Reported as group
Promoting interoperability
87
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue154
Removal of skin lesions1-10
Removal of nail tissue463
Removal or shaving of skin growth216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO3780FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Foot & Ankle Surgery CurrentSince Jan 1, 2021 Accepting new patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Foot & Ankle Surgery CurrentSince Jan 1, 2021 Accepting new patients
Mt Washington Pediatric Hospital Inc Past Accepting new patients

Locations

66 Parkway Ln
Ste 102
Fishersville, VA 22939
Phone (540) 949-5150

1 Arh Ln
Ste 101
Low Moor, VA 24457
Phone (304) 647-5652

1 Dudley St
Martinsville, VA 24112
Phone (276) 638-5128

101 1st St NW
Pulaski, VA 24301
Phone (276) 322-1800

60 Summerfield Ct
#102
Roanoke, VA 24019
Phone (540) 904-1458

222 Walnut Ave SW
Roanoke, VA 24016
Phone (540) 344-3668

150 Spartan Dr
Salem, VA 24153
Phone (540) 382-4221

1802 Braeburn Dr
Ste A2130
Salem, VA 24153
Phone (540) 344-3668

1802 Braeburn Dr
Ste M120
Salem, VA 24153
Phone (540) 344-3668

Organizations & group practices 3

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": "1462579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462579200000",
    "number": "1689020703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 WALNUT AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 WALNUT AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164723",
            "telephone_number": "540-344-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIANO",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-07",
        "last_updated": "2016-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103301173",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3780",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.