Individual provider Active NPI

Anthony John Visalli, D.P.M.

  • Podiatrist
  • Forest Hill, MD
National Provider Identifier
1922112481
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
01075 Issued in MD
Practice address
109 Forest Valley Dr
Forest Hill, MD 21050-2831
Phone
(410) 838-0101
Fax
(410) 893-3343
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 01075 MD Primary

Addresses

Primary practice location

109 Forest Valley Dr
Forest Hill, MD 21050-2831

Mailing address

19 Beecham CT
Suite 204
Owings Mills, MD 21117-6001
Phone (410) 654-8602

Other identifiers 1

IdentifierTypeStateIssuer
020188000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20111123000046 MD Practitioner - Podiatry 3678747953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

515 Brightfield Rd
Lutherville, MD 21093-3643
Phone (410) 296-1990

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual
Quality
30
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1157
Removal or shaving of skin growth441

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1075MDMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Polun Family Footcare P C Podiatrist CurrentSince Jan 1, 2011 Accepting new patients
Nurse Practitioners and Consultants P C Past Accepting new patients
Premier Podiatry of Virginia LLC Podiatrist Past Accepting new patients

Locations

1300 S Ellwood Ave
Baltimore, MD 21224
Phone (410) 342-6644

4800 Seton Dr
Baltimore, MD 21215
Phone (410) 358-3410

109 Forest Valley Dr
Forest Hill, MD 21050
Phone (410) 776-6038

10989 Red Run Blvd
Ste 208
Owings Mills, MD 21117

6811 Campfield Rd
Pikesville, MD 21207
Phone (410) 486-4573

515 Brightfield Rd
Timonium, MD 21093
Phone (410) 296-1990

Interoperability endpoints

  • Direct secure messaging: anthony.visalli@3388.securemail.prognocis.com

Organizations & group practices 3

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1922112481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BEECHAM CT",
            "address_2": "SUITE 204",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211176001",
            "telephone_number": "410-654-8602",
            "fax_number": "410-654-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 FOREST VALLEY DR",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502831",
            "telephone_number": "410-838-0101",
            "fax_number": "410-893-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISALLI",
        "first_name": "ANTHONY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "01075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020188000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hill, MD

Sources for this page

Verify at the official NPI Registry.