IAN MICHAEL WATTENMAKER (M.D.) – Orthopaedic Surgery Physician, NPI 1629077854

IAN MICHAEL WATTENMAKER (M.D.) is a healthcare provider. based in Leesburg, Virginia. specializing in Orthopaedic Surgery Physician. They hold the professional credentials M.D.. They hold a License No. 0101049672 (VA). The NPI Number for IAN MICHAEL WATTENMAKER (M.D.) is 1629077854

Main info

Male
40 Years Of Experience
Accepts Medicare Assignment
Name
IAN MICHAEL WATTENMAKER (M.D.)
NPI
1629077854
Phone
(703) 777-1553
Address
19450 DEERFIELD AVE STE 300
Enumeration Date
19 July 2005
Last Update Date
18 March 2024

Doctor Profile

Medical School Name
PERELMAN SCHOOL OF MED AT THE UNIVERSITY OF PENNSYLVANIA
Secondary Phone
7037376001
Graduation Year
1986 (40 years ago)
PAC ID
1052210697
Group Practice PAC ID
0042119661
Professional Enrollment ID
I20080616000105
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for IAN MICHAEL WATTENMAKER (M.D.)

  • 19450 DEERFIELD AVE STE 300

    LEESBURG, VA 201766821

    Phone: (703) 777-1553

    Fax: (703) 777-5524

    Type: Location

  • 19450 DEERFIELD AVENUE, SUITE 300

    LEESBURG, VA 201766821

    Phone: (703) 777-1553

    Fax: (703) 777-5524

    Type: Location

  • 19450 DEERFIELD AVENUE, SUITE 200

    LEESBURG, VA 201766821

    Phone: (703) 777-1553

    Fax: (703) 777-5524

    Type: Location

  • 224D CORNWALL ST NW STE 403

    LEESBURG, VA 201762704

    Phone: (703) 737-6010

    Fax: (703) 443-8643

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-06-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080616000105IOrthopedic SurgeryVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 20176)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042119661View full group profile

Reviews

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Frequently asked questions

How is IAN MICHAEL WATTENMAKER (M.D.) identified in CMS data?
CMS-hosted NPPES data lists IAN MICHAEL WATTENMAKER (M.D.) with NPI 1629077854.
Does CMS list IAN MICHAEL WATTENMAKER (M.D.) as active?
Yes — IAN MICHAEL WATTENMAKER (M.D.) is active in the NPI listing used on this page.
What healthcare role does IAN MICHAEL WATTENMAKER (M.D.) hold?
Scheduling teams often label IAN MICHAEL WATTENMAKER (M.D.) under Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
What address line appears for IAN MICHAEL WATTENMAKER (M.D.)?
IAN MICHAEL WATTENMAKER (M.D.)'s geographic hint is Leesburg, Virginia in our summary view.
Why does IAN MICHAEL WATTENMAKER (M.D.) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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