Individual provider Active NPI

Judith Olkaba, DPM

  • Foot Surgery Podiatrist
  • Dumfries, VA
National Provider Identifier
1891952875
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
0103300998 Issued in VA
Practice address
3700 Fettler Park Dr
Dumfries, VA 22025-2050
Phone
(703) 441-7500
NPI assigned
May 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 01472 MD
Foot Surgery Podiatrist 213ES0131X 0103300998 VA Primary

Addresses

Primary practice location

3700 Fettler Park Dr
Dumfries, VA 22025-2050

Mailing address

3700 Fettler Park Dr
Dumfries, VA 22025-2050

Other identifiers 2

IdentifierTypeStateIssuer
VVU534AOtherVAMEDICARE
1891952875MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, 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
I20091217000421 MD Practitioner - Podiatry 6406996719 Reassigns benefits to 1 organization
I20190328001962 VA Practitioner - Podiatry 6406996719 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01472MDMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Calvert Ambulatory Foot Surgery Center CurrentSince Nov 20, 2016 Accepting new patients
Privia Medical Group, LLC Podiatrist CurrentSince Nov 7, 2020 Accepting new patients
DRS Hertz and Idol DPM, PA Podiatrist CurrentSince Nov 1, 2009 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 7, 2020 Accepting new patients
Ridgeline Physician Services, LLC Past Accepting new patients

Locations

1430 Solomons Island Rd
Huntingtown, MD 20639
Phone (301) 884-6056

15237 Creativity Dr
Culpeper, VA 22701
Phone (540) 321-4281

8644 Sudley Rd
#220
Manassas, VA 20110

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.

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1891952875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 FETTLER PARK DR",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220252050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 FETTLER PARK DR",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220252050",
            "telephone_number": "703-441-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLKABA",
        "first_name": "JUDITH",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "01472",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "VA",
            "license": "0103300998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "VVU534A",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891952875",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dumfries, VA

Sources for this page

Verify at the official NPI Registry.