Victor R. Aybar,DPM,PA
Organization Active NPI Podiatrist · Manchester, MD
NPI 1972795367 · NPPES record last updated Dec 17, 2018
Key facts
- NPI
- 1972795367
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Podiatrist 213E00000X
- License
- 01134 (MD)
- Legal business name
- VICTOR R. AYBAR,DPM,PA
- Practice address
- 2963 Manchester Rd Ste D
Manchester, MD 21102-1853 - Phone
- (410) 374-2229
- Fax
- (410) 374-2281
- NPI assigned
- Aug 9, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Victor R Aybar
- Title
- President
- Phone
- (410) 374-2229
Practitioners 1
-
Victor R Aybar, D.P.M.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100817000722 | MD | Part B Supplier - Clinic/Group Practice | 7517091291 |
Receives reassigned benefits from 1 practitioner Practice locations: Manchester, MD |
| O20100930077668 | MD | DME Supplier - Physician - Podiatry | 7517091291 | Practice locations: Manchester, MD |
National Provider Directory
Locations
2963 Manchester Rd
Ste D
Manchester, MD 21102
Phone (410) 374-2229
10706 Reisterstown Rd
Owings Mills, MD 21117
Phone (410) 356-0222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist |
213E00000X | 01134 | MD | Yes |
Addresses
Primary practice location
2963 Manchester Rd Ste D
Manchester, MD 21102-1853
Mailing address
10706 Reisterstown Rd
Owings Mills, MD 21117-2720
Other practice location 1
10706 Reisterstown Rd
Owings Mills, MD 21117-2720
Phone (410) 356-0222
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 759748701 | Medicaid | MD | |
| 958036 | Other | MD | AETNA |
| R2660001 | Other | MD | BLUECHOICE |
| R2660001 | Other | MD | BC/BS FEDERAL |
| 2103244 | Other | MD | OPTIMUM CHOICE |
| 52584001 | Other | MD | BC/BS |
Other providers in Manchester, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.