Healthcare Provider Details

I. General information

NPI: 1093124778
Provider Name (Legal Business Name): FREDERICK FOOT AND ANKLE SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2014
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 THOMAS JOHNSON DR SUITE 170
FREDERICK MD
21702
US

IV. Provider business mailing address

141 THOMAS JOHNSON DR SUITE 170
FREDERICK MD
21702
US

V. Phone/Fax

Practice location:
  • Phone: 301-668-9707
  • Fax: 301-668-4927
Mailing address:
  • Phone: 301-668-9707
  • Fax: 301-668-4927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. YENISEY YANES
Title or Position: PRESIDENT
Credential: DPM
Phone: 240-575-2222