Active NPI
Ian Thomas Greenwalt, M.D.
- Surgery Physician
- Haymarket, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 0101283801
- Practice address
- 15195 Heathcote Blvd Ste 240
Haymarket, VA 20169-6245 - Phone
- (571) 284-3460
- NPI assigned
- Mar 27, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Oncology Physician | 2086X0206X | MD047318 | DC | |
| Surgery Physician | 208600000X | 0101283801 | VA | Primary |
Addresses
Primary practice location
15195 Heathcote Blvd Ste 240
Haymarket, VA 20169-6245
Mailing address
PO Box 748613
Atlanta, GA 30384-8613
Phone (434) 295-1000
Other practice location 1
3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone (202) 295-0560
Other practice location 2
15225 Heathcote Blvd
Haymarket, VA 20169-6264
Phone (571) 284-1000
Other practice location 3
8700 Sudley Rd
Manassas, VA 20110-4418
Phone (703) 369-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Drexel University College of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
15195 Heathcote Blvd
Suite 240
Haymarket, VA 20169-6245
Phone (571) 284-3460
Hospital & facility affiliations
- Uva Health Haymarket Medical Center
- Uva Health Prince William Medical Center
- Medstar Georgetown University Hospital
- Fauquier Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.34 of 100
- Quality
- 67.9
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 69.47
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 27 |
| Melanoma (skin cancer) excision | 14 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD047318 | DC | MD | Surgical Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Medical Group II LLC | Current | Accepting new patients | |
| Medstar Medical Group II LLC | Current | Accepting new patients | |
| Uva Community Health Medical Group, LLC | Current | Accepting new patients | |
| Uva Community Health Medical Group, LLC | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401
3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203
4105 Lewis and Clark Dr
Charlottesvle, VA 22911
15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000
15195 Heathcote Blvd
Ste 240
Haymarket, VA 20169
Phone (571) 261-2782
8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000
Interoperability endpoints
- igreenwalt647889@direct.healthsystem.virginia.edu
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Charlottesville, VA
- NPI 1598475741
-
- Internal Medicine Physician
- Washington, DC
- NPI 1376887844
-
- Family Medicine Physician
- Manassas, VA
- NPI 1366744039
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Warrenton, VA
- NPI 1912334517
-
- General Acute Care Hospital
- Haymarket, VA
- NPI 1124369137
-
- General Acute Care Hospital
- Manassas, VA
- NPI 1417005760
-
- General Acute Care Hospital
- Washington, DC
- NPI 1427145176
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733443200000",
"number": "1720405665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 748613",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303848613",
"telephone_number": "434-295-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15195 HEATHCOTE BLVD STE 240",
"city": "HAYMARKET",
"state": "VA",
"postal_code": "201696245",
"telephone_number": "571-284-3460"
}
],
"practiceLocations": [
{
"address_1": "3800 Reservoir Rd NW",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200072113",
"country_code": "US",
"telephone_number": "202-295-0560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15225 Heathcote Blvd",
"address_purpose": "LOCATION",
"city": "Haymarket",
"state": "VA",
"postal_code": "201696264",
"country_code": "US",
"telephone_number": "571-284-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8700 Sudley Rd",
"address_purpose": "LOCATION",
"city": "Manassas",
"state": "VA",
"postal_code": "201104418",
"country_code": "US",
"telephone_number": "703-369-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREENWALT",
"first_name": "IAN",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-27",
"last_updated": "2024-12-06",
"certification_date": "2024-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "DC",
"license": "MD047318",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "VA",
"license": "0101283801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Haymarket, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.