Abe Charles Bagniewski, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO00000775 Issued in WA

Practice address

165 Lilly Rd NE
Olympia, WA 98506-5086

Phone

(360) 438-9092

NPI assigned

Jul 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Ipp PC

  dba Interventional Pain Program, Ericson Hand and Nerve Center

  • Specialist
  • Bothell, WA
  • NPI 1225114929
  NPD (past)
• Kelley a. Gillroy-Gill

  dba Cascade Foot and Ankle Clinic

  • Foot & Ankle Surgery Podiatrist
  • Olympia, WA
  • NPI 1750775037
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1790790376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 LILLY RD NE STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065086",
            "telephone_number": "360-438-9092",
            "fax_number": "360-438-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065086",
            "telephone_number": "360-438-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGNIEWSKI",
        "first_name": "ABE",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO00000775",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO00000775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0204603",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001166",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8940526",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Jean Bacigalupo, SUDPT
• Back in Motion Chiropractic P.C. (Back In Motion Chiropractic)
• Destiny Bacon
• Bahram Badri
• Julia Elizabeth Bagley, M.S.
• Ryan Christopher Bahl, AU.D.
• Christopher Bailey, DVM
• Nicole A Bailey
• Robin Lynne Bailey
• Rose H. Bailey, DDS

• Foot & Ankle Surgery Podiatrist in Olympia, WA
• Providers in Olympia, WA by specialty
• Foot & Ankle Surgery Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.