Andy Roussel (NPI# 1417920117, PAC ID# 5698877025) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PODIATRY.
| Nation Provider ID (NPI) | 1417920117 |
| PAC ID by PECOS | 5698877025 |
| Professional Enrollment ID | I20070302000394 |
| Full Name | Andy Roussel |
| Organization Legal Name | ASSOCIATED FOOT AND ANKLE CENTERS OF NORTHERN VIRGINIA PC |
| Address |
1721 Financial Loop Lake Ridge VA 22192-2460 |
| Phone Number | 7034919500 |
| Gender | M |
| Credential | DPM |
| Medical School | BARRY UNIVERSITY SCHOOL PODIATRIC MEDICINE |
| Graduation Year | 2003 |
| Primary Specialty | PODIATRY |
| Group Practice PAC ID | 6507843877 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490063 | INOVA FAIRFAX HOSPITAL |
| 490113 | SENTARA NORTHERN VIRGINIA MEDICAL CENTER |
| 490140 | STAFFORD HOSPITAL, LLC |
| Address | Phone | Organization |
|---|---|---|
| 10730 Main St, Fairfax, VA 22030-3704 | 7034919500 | ASSOCIATED FOOT AND ANKLE CENTERS OF NORTHERN VIRGINIA PC |
| 1721 Financial Loop, Lake Ridge, VA 22192-2460 | 7034919500 | ASSOCIATED FOOT AND ANKLE CENTERS OF NORTHERN VIRGINIA PC |
| 945 Garrisonville Rd, Stafford, VA 22556-3906 | 5407200700 | ASSOCIATED FOOT AND ANKLE CENTERS OF NORTHERN VIRGINIA PC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% |
| Organization Legal Name | ASSOCIATED FOOT AND ANKLE CENTERS OF NORTHERN VIRGINIA PC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark L Scripps | Podiatry | Associated Foot and Ankle Centers of Northern Virginia PC | 1721 Financial Loop, Lake Ridge, VA 22192-2460 |
| Corine Leigh Creech | Podiatry | Associated Foot and Ankle Centers of Northern Virginia PC | 1721 Financial Loop, Lake Ridge, VA 22192-2460 |
| Douglas E Stabile | Podiatry | Associated Foot and Ankle Centers of Northern Virginia PC | 1721 Financial Loop, Lake Ridge, VA 22192-2460 |
| Richard Derner | Podiatry | Associated Foot and Ankle Centers of Northern Virginia PC | 1721 Financial Loop, Lake Ridge, VA 22192-2460 |
| Street Address |
1721 FINANCIAL LOOP |
| City | LAKE RIDGE |
| State | VA |
| Zip | 22192-2460 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark L Scripps | Podiatry | Associated Foot and Ankle Centers of Northern Virginia PC | 1721 Financial Loop, Lake Ridge, VA 22192-2460 |
| Corine Leigh Creech | Podiatry | Associated Foot and Ankle Centers of Northern Virginia PC | 1721 Financial Loop, Lake Ridge, VA 22192-2460 |
| Douglas E Stabile | Podiatry | Associated Foot and Ankle Centers of Northern Virginia PC | 1721 Financial Loop, Lake Ridge, VA 22192-2460 |
| Richard Derner | Podiatry | Associated Foot and Ankle Centers of Northern Virginia PC | 1721 Financial Loop, Lake Ridge, VA 22192-2460 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Peter A Mendel | Family Medicine | Family Medicine of Lake Ridge PC | 3401 Commission Ct, Suite 201, Woodbridge, VA 22192-1771 |
| John James Wierzbicki | Family Medicine | Family Medicine of Lake Ridge PC | 3401 Commission Ct, Suite 201, Woodbridge, VA 22192-1771 |
| Julie D Oglesby | Nurse Practitioner | Family Medicine of Lake Ridge PC | 3401 Commission Ct, Suite 201, Woodbridge, VA 22192-1771 |
| Christian Lavenia | Nurse Practitioner | Rahel G. Yirga Md PC | 12185 Clipper Dr, Lake Ridge, VA 22192-2236 |
| Phuong Xuan Mai | Internal Medicine | 12191 Clipper Dr, Lake Ridge, VA 22192-2237 | |
| Oluwaseyi Bolaji Bolorunduro | Cardiovascular Disease (cardiology) | Nova Cardiovascular Care LLC Nvcc | 1990 Old Bridge Rd, Suite 201, Woodbridge, VA 22192-2383 |
| Amy Friedenthal | Internal Medicine | 12512 D Lake Ridge Dr, Woodbridge, VA 22192-2386 | |
| Abucar A Abdulle | Internal Medicine | 12761 Darby Brook Ct, Suite 101, Woodbridge, VA 22192-2405 | |
| Jaime L Parker | Clinical Social Worker | Woodbridge Therapy Group LLC | 12721 Darby Brook Ct, Suite 102, Woodbridge, VA 22192-2408 |
| Hemini P Naik | Psychologist, Clinical | Woodbridge Therapy Group LLC | 12721 Darby Brook Ct, Suite 102, Woodbridge, VA 22192-2408 |
| Find all physicians in zip 22192 | |||
| City | LAKE RIDGE |
| Zip Code | 22192 |
| Specialty | PODIATRY |
| City + Specialty | LAKE RIDGE + PODIATRY |
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| 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.