Active NPI
Dr Ivan J Nosacek PA
- Podiatrist
- Bowie, MD
National Provider Identifier
1992807770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 00982
- Legal business name
- DR IVAN J NOSACEK PA
- Practice address
- 3006 Mitchellville Rd
Bowie, MD 20716-1300 - Phone
- (301) 390-3338
- Fax
- (301) 390-7738
- NPI assigned
- Sep 2, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ivan John Nosacek, DPM
- Title
- President
- Phone
- (301) 390-3338
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 00982 | MD | Primary |
Addresses
Primary practice location
3006 Mitchellville Rd
Bowie, MD 20716-1300
Mailing address
3006 Mitchellville Rd
Bowie, MD 20716-1300
Phone (301) 390-3338
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 066038800 | Medicaid | MD |
Other names 1
- Ivan J. Nosacek DPM
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
3006 Mitchellville Rd
Bowie, MD 20716
Phone (301) 390-3338
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1212451200000",
"number": "1992807770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3006 MITCHELLVILLE RD",
"city": "BOWIE",
"state": "MD",
"postal_code": "207161300",
"telephone_number": "301-390-3338",
"fax_number": "301-390-7738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3006 MITCHELLVILLE RD",
"city": "BOWIE",
"state": "MD",
"postal_code": "207161300",
"telephone_number": "301-390-3338",
"fax_number": "301-390-7738"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DR IVAN J NOSACEK PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-02",
"last_updated": "2008-06-03",
"status": "A",
"authorized_official_last_name": "NOSACEK",
"authorized_official_first_name": "IVAN",
"authorized_official_middle_name": "JOHN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "301-390-3338",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "MD",
"license": "00982",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "066038800",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Ivan J. Nosacek DPM",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.