Individual provider Active NPI

Lonny Nodelman, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Fairfax, VA
National Provider Identifier
1891058921
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0103301147 Issued in VA
Practice address
3020 Hamaker CT
201
Fairfax, VA 22031-2238
Phone
(703) 207-0073
NPI assigned
Jun 22, 2012
Last updated
Aug 28, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1284 MA
Foot & Ankle Surgery Podiatrist 213ES0103X 0103301147 VA Primary

Addresses

Primary practice location

3020 Hamaker CT
201
Fairfax, VA 22031-2238

Mailing address

3020 Hamaker CT
201
Fairfax, VA 22031-2238
Phone (703) 207-0073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150930002040 DC Practitioner - Podiatry 3072821628 Reassigns benefits to 3 organizations
I20250918000396 VA Practitioner - Podiatry 3072821628 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
District Foot and AnkleGroup PAC ID 5991034225, 2 clinicians

Practice addresses (Care Compare)

224 D Cornwall St NW
Suite 203
Leesburg, VA 20176-2700
Phone (703) 832-9013

4875 Eisenhower Ave
Suite 230
Alexandria, VA 22304-4833
Phone (703) 832-9013

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue257
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1284MAMDPodiatrist
0103301147VAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
District Foot and Ankle Foot & Ankle Surgery CurrentSince Jan 22, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Podiatrist CurrentSince May 6, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince May 6, 2019 Accepting new patients

Locations

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

4875 Eisenhower Ave
Ste 230
Alexandria, VA 22304
Phone (703) 832-9013

224D Cornwall St NW
Ste 203
Leesburg, VA 20176
Phone (703) 777-5830

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: lnodelman@dfaa-va.direct.office.nextgen.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1891058921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 HAMAKER CT",
            "address_2": "201",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312238",
            "telephone_number": "703-207-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 HAMAKER CT",
            "address_2": "201",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312238",
            "telephone_number": "703-207-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NODELMAN",
        "first_name": "LONNY",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-22",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1284",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103301147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.