Stanley Idiculla (NPI# 1043274368, PAC ID# 0042306391) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PREVENTATIVE MEDICINE.
| Nation Provider ID (NPI) | 1043274368 |
| PAC ID by PECOS | 0042306391 |
| Professional Enrollment ID | I20090224000705 |
| Full Name | Stanley Idiculla |
| Organization Legal Name | NOVA FOOT AND ANKLE |
| Address |
112 Elden St Suite D Herndon VA 20170-4832 |
| Phone Number | 7034375353 |
| Gender | M |
| Medical School | NEW YORK COLLEGE OF PODIATRIC MEDICINE |
| Graduation Year | 2004 |
| Primary Specialty | PREVENTATIVE MEDICINE |
| Group Practice PAC ID | 2860630613 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490107 | RESTON HOSPITAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 112 Elden St, Suite D, Herndon, VA 20170-4832 | 7034375353 | NOVA FOOT AND ANKLE |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_047_overall | Care Plan | 0% |
| Organization Legal Name | NOVA FOOT AND ANKLE |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ami Parikh | Podiatry | Nova Foot and Ankle | 112 Elden St, Suite D, Herndon, VA 20170-4832 |
| Tiomara Paylor | Podiatry | Nova Foot and Ankle | 112 Elden St, Suite D, Herndon, VA 20170-4832 |
| Street Address |
112 ELDEN ST SUITE D |
| City | HERNDON |
| State | VA |
| Zip | 20170-4832 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ami Parikh | Podiatry | Nova Foot and Ankle | 112 Elden St, Suite D, Herndon, VA 20170-4832 |
| Tiomara Paylor | Podiatry | Nova Foot and Ankle | 112 Elden St, Suite D, Herndon, VA 20170-4832 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Catherine E Wycoff | Physical Therapy | 307 Marjorie Lane, Herndon, VA 20170-3334 | |
| Wendy W Roberts | Clinical Social Worker | 204 Herndon Station Sq, Herndon, VA 20170-3756 | |
| Patricia L Carnes | Nurse Practitioner | Minuteclinic Diagnostic of Virginia LLC | 1062 Elden St, Suite 1402, Herndon, VA 20170-3803 |
| Jacquelyn D Katz | Nurse Practitioner | Minuteclinic Diagnostic of Virginia LLC | 1062 Elden St, Suite 1402, Herndon, VA 20170-3803 |
| Lindsay S Witte | Nurse Practitioner | Minuteclinic Diagnostic of Virginia LLC | 1062 Elden St, Suite 1402, Herndon, VA 20170-3803 |
| Nonye T Aghanya | Nurse Practitioner | Minuteclinic Diagnostic of Virginia LLC | 1062 Elden St, Suite 1402, Herndon, VA 20170-3803 |
| Han Tonthat | Internal Medicine | 1041 Sterling Rd, Suite 106, Herndon, VA 20170-3841 | |
| Rajitha Siddineni | Family Medicine | Millenium Medical Corp | 1043 Sterling Rd, Suite 104, Herndon, VA 20170-3842 |
| Amee K Mehta | Family Medicine | Millenium Medical Corp | 1043 Sterling Rd, Suite 104, Herndon, VA 20170-3842 |
| Sapna Sharma | Internal Medicine | Millenium Medical Corp | 1043 Sterling Rd, Suite 104, Herndon, VA 20170-3842 |
| Find all physicians in zip 20170 | |||
| City | HERNDON |
| Zip Code | 20170 |
| Specialty | PREVENTATIVE MEDICINE |
| City + Specialty | HERNDON + PREVENTATIVE MEDICINE |
Please comment or provide details below to improve the information on Stanley Idiculla.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.