NPIMap

Organization Active NPI

Reconstructive Foot & Ankle Institute, LLC

  • Foot & Ankle Surgery Podiatrist
  • Hagerstown, MD
National Provider Identifier
1871655381
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
RECONSTRUCTIVE FOOT & ANKLE INSTITUTE, LLC
Practice address
1150 Professional CT
Suite C
Hagerstown, MD 21740-5852
Phone
(301) 797-8554
Fax
(301) 797-8281
NPI assigned
Dec 14, 2006
Last updated
Jan 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Authorized official

Name
Dr. Daniel Dale Michaels, DPMNPI 1073615373
Title
Owner
Phone
(301) 797-8554

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

1150 Professional CT
Suite C
Hagerstown, MD 21740-5852

Mailing address

PO Box 269
Frederick, MD 21705-0269
Phone (301) 797-8554

Other identifiers 3

IdentifierTypeStateIssuer
J323OtherDCBCBS
290AOtherMDCAREFIRST MD
DC3915OtherMDMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050114000164 MD Part B Supplier - Clinic/Group Practice 7719936913 Receives reassigned benefits from 1 practitioner
Practice locations: Hagerstown, MD; Frederick, MD
O20100930061471 MD DME Supplier - Physician - Podiatry 7719936913 Practice locations: Hagerstown, MD

National Provider Directory

National Provider Directory
Tax ID family
Reconstructive Foot Ankle4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1871655381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217050269",
            "telephone_number": "301-797-8554",
            "fax_number": "301-797-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 PROFESSIONAL CT",
            "address_2": "SUITE C",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405852",
            "telephone_number": "301-797-8554",
            "fax_number": "301-797-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECONSTRUCTIVE FOOT & ANKLE INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "MICHAELS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-797-8554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J323",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD",
            "identifier": "290A",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DC3915",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.