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SHADY GROVE PODIATRY, LLC
NPI 1518083443
Podiatrist - Foot & Ankle Surgery in Gaithersburg, MD

Active since March 22, 2007
16220 S FREDERICK AVE, SUITE 427, GAITHERSBURG, MD 20877(301) 948-2995(301) 948-6056 Get Directions Write a Review

NPPES record last updated: September 13, 2011. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Shady Grove Podiatry, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHADY GROVE PODIATRY, LLC (NPI 1518083443) is a healthcare organization registered as a foot & ankle surgery in Gaithersburg, Maryland and active in the NPI registry since March 2007. The organization lists Ronald Allen Footer, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1518083443
Entity TypeOrganization
Primary Taxonomy213ES0103X
Legal Business NameSHADY GROVE PODIATRY, LLC
Location Address16220 S FREDERICK AVE, SUITE 427Gaithersburg, MD 20877-4039
Mailing Address16220 S Frederick Ave, Suite 427Gaithersburg, MD 20877-4039 · (301) 948-2995 · Fax (301) 948-6056
Phone(301) 948-2995
Fax(301) 948-6056
Organization SubpartNo
Authorized OfficialRonald Allen FooterManaging Partner · (301) 948-2995
Enumeration DateMarch 22, 2007
Last NPPES UpdateSeptember 13, 2011
✔ NPI 1518083443 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in MD · 00360
16220 S FREDERICK AVE, Gaithersburg, MD 20877
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Other Identifiers 2

Medicare ID-Type UnspecifiedG01798MH · Medicare Group Number
Medicare NSC5294240001MD

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shady Grove Podiatry, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Shady Grove Podiatry, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Jonathan Dillard, DPM
Podiatry
NPI 1427579770
16220 FREDERICK RD STE 427
Gaithersburg, MD 20877
(301) 948-2995
✔ PECOS✔ Accepts MedicareSame address
Amir Assili, DPM
Podiatry
NPI 1164448825
16220 S FREDERICK AVE SUITE 427
Gaithersburg, MD 20877
(301) 948-2995
✔ PECOS✔ Accepts Medicare0.1 mi
David Baek, DPM
Podiatry
NPI 1508884321
16220 FREDERICK AVE SUITE 427
Gaithersburg, MD 20877
(301) 948-2995
✔ PECOS✔ Accepts Medicare0.1 mi
Navid Sadoughi, DPM
Podiatry
NPI 1992117477
4600 N PARK AVE STE G1N
Chevy Chase, MD 20815
(240) 641-8735
✔ PECOS✔ Accepts Medicare12 mi
David Lin, DPM
Podiatry
NPI 1497066377
16 N LA PLATA CT
La Plata, MD 20646
(301) 392-3330
✔ PECOS✔ Accepts Medicare40 mi
Hoan Dang, DPM
Podiatry
NPI 1063777811
10800 KNIGHTS RD
Philadelphia, PA 19114
(215) 612-5161
✔ PECOS✔ Accepts Medicare134 mi
Colin Mizuo, DPM
Podiatry
NPI 1427410679
5050 NE HOYT ST STE 223
Portland, OR 97213
(503) 963-2964
✔ PECOS✔ Accepts Medicare2,337 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shady Grove Podiatry, LLC's NPI number?

The NPI number for Shady Grove Podiatry, LLC is 1518083443. It was assigned to this organization in the NPPES registry on March 22, 2007.

Where is Shady Grove Podiatry, LLC located?

Shady Grove Podiatry, LLC is located at 16220 S Frederick Ave Suite 427, Gaithersburg, MD 20877. The listed phone number is (301) 948-2995.

What is Shady Grove Podiatry, LLC's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Shady Grove Podiatry, LLC enrolled in Medicare?

Yes. Shady Grove Podiatry, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Shady Grove Podiatry, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians, all in Podiatry, reassign their Medicare billing to Shady Grove Podiatry, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Shady Grove Podiatry, LLC was last updated on September 13, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.