Mentor Thaqi, DPM/PHD

Primary specialty

PodiatristTaxonomy code 213E00000X

License

0103301508 Issued in VA

Practice address

3 Riverside Cir
Roanoke, VA 24016-4955

Phone

(540) 510-6200

Fax

(540) 857-5306

NPI assigned

May 1, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1902595523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RIVERSIDE CIR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164955",
            "telephone_number": "540-510-6200",
            "fax_number": "540-857-5306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20000 Harvard Ave",
            "address_purpose": "LOCATION",
            "city": "Warrensville Heights",
            "state": "OH",
            "postal_code": "441226805",
            "country_code": "US",
            "telephone_number": "216-491-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14601 Detroit Ave",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "OH",
            "postal_code": "441074205",
            "country_code": "US",
            "telephone_number": "216-237-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9500 Euclid Ave # Jj24",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441950001",
            "country_code": "US",
            "telephone_number": "216-444-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18101 Lorain Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441115612",
            "country_code": "US",
            "telephone_number": "216-476-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAQI",
        "first_name": "MENTOR",
        "credential": "DPM/PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-01",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103301508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madisson Leeann Billings Terry, NP
• Yusef U Terry, PA-C
• Daniel R Tershak, M.D.
• Mackenzie Noelle Tewksbury, PA-C
• Ayush Sureshbhai Thakkar
• Amy M. Tharp, MD
• Anusha Singh Thayagan, OTR
• Albert Joseph Thayil, D.O.
• The Arts & Science of Dermatology, PC
• The Bearded LCSW, LLC

• Podiatrist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.