Active NPI
Ira Steckler Groban, DPM
- Podiatrist
- Washington, DC
National Provider Identifier
1780799270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 314
- Practice address
- 3900 16TH Street NW
#115
Washington, DC 20011 - Phone
- (202) 234-5420
- Fax
- (202) 723-9020
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 314 | DC | Primary |
| Podiatrist | 213E00000X | 509 | MD |
Addresses
Primary practice location
3900 16TH Street NW
#115
Washington, DC 20011
Mailing address
3900 16TH Street NW
#115
Washington, DC 20011
Phone (202) 234-5420
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010681700 | Medicaid | DC | |
| 1064 | Other | DC | BCBS NCA |
| 987928500 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 314 | DC | MD | Podiatrist |
| 509 | MD | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281916800000",
"number": "1780799270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 16TH STREET NW",
"address_2": "#115",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "20011",
"telephone_number": "202-234-5420",
"fax_number": "202-723-9020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 16TH STREET NW",
"address_2": "#115",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "20011",
"telephone_number": "202-234-5420",
"fax_number": "202-723-9020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROBAN",
"first_name": "IRA",
"middle_name": "STECKLER",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2010-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "DC",
"license": "314",
"primary": true
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MD",
"license": "509",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010681700",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NCA",
"identifier": "1064",
"state": "DC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "987928500",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.