NPIMap

Organization Active NPI

Stockdale Podiatry Group Inc

  • Foot & Ankle Surgery Podiatrist
  • Bakersfield, CA
National Provider Identifier
1013013002
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
STOCKDALE PODIATRY GROUP INC
Practice address
110 New Stine Rd
Bakersfield, CA 93309-2605
Phone
(661) 832-1666
Fax
(661) 832-2039
NPI assigned
Sep 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brandon Hawkins, DPMNPI 1073587663
Title
Doctor/Owner
Phone
(661) 832-1666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X CA Primary

Addresses

Primary practice location

110 New Stine Rd
Bakersfield, CA 93309-2605

Mailing address

110 New Stine Rd
Bakersfield, CA 93309-2605
Phone (661) 832-1666

Other practice location 1

448 W Putnam Ave
Porterville, CA 93257-3321
Phone (559) 784-3118

Other practice location 2

951 E Merritt Ave
Tulare, CA 93274-2221
Phone (661) 832-1667

Other practice location 3

1519 Garces Hwy Ste 107
Delano, CA 93215-3694
Phone (661) 725-1664

Other identifiers 5

IdentifierTypeStateIssuer
E4648OtherCALIC # HAWKINS
A76044OtherCALIC-MIHALUTA
E3008OtherCALIC-DR.HAMILTON
E3891OtherCALIC-DR.PASABOC
E3301OtherCALIC-DR.MILLER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041027000646 CA Part B Supplier - Clinic/Group Practice 0143282715 Receives reassigned benefits from 14 practitioners
Practice locations: Porterville, CA; Visalia, CA; Tulare, CA; Delano, CA; Costa Mesa, CA; Bakersfield, CA
O20100930015156 CA DME Supplier - Physician - Podiatry 0143282715 Practice locations: Bakersfield, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2152724Stockdale Podiatry Group, Inc110 New Stine Rd, Bakersfield, CA 93309ComplianceSep 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Stockdale Podiatry Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1701 27th St
Bakersfield, CA 93301
Phone (661) 322-2895

8307 Brimhall Rd
Ste 1704
Bakersfield, CA 93312
Phone (661) 829-7415

3501 Mall View Rd
Ste 104
Bakersfield, CA 93306

110 New Stine Rd
#R
Bakersfield, CA 93309

3857 Stockdale Hwy
Bakersfield, CA 93309
Phone (619) 832-1667

1700 Adams Ave
Ste 204
Costa Mesa, CA 92626
Phone (714) 434-1776

420 34th St
Los Angeles, CA 90074

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1013013002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 NEW STINE RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933092605",
            "telephone_number": "661-832-1666",
            "fax_number": "661-832-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 NEW STINE RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933092605",
            "telephone_number": "661-832-1666",
            "fax_number": "661-832-2039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "448 W Putnam Ave",
            "address_purpose": "LOCATION",
            "city": "Porterville",
            "state": "CA",
            "postal_code": "932573321",
            "country_code": "US",
            "telephone_number": "559-784-3118",
            "fax_number": "559-784-7486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "951 E Merritt Ave",
            "address_purpose": "LOCATION",
            "city": "Tulare",
            "state": "CA",
            "postal_code": "932742221",
            "country_code": "US",
            "telephone_number": "661-832-1667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1519 Garces Hwy Ste 107",
            "address_purpose": "LOCATION",
            "city": "Delano",
            "state": "CA",
            "postal_code": "932153694",
            "country_code": "US",
            "telephone_number": "661-725-1664",
            "fax_number": "661-725-2786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STOCKDALE PODIATRY GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "661-832-1666",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC # HAWKINS",
            "identifier": "E4648",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC-MIHALUTA",
            "identifier": "A76044",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC-DR.HAMILTON",
            "identifier": "E3008",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC-DR.PASABOC",
            "identifier": "E3891",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC-DR.MILLER",
            "identifier": "E3301",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.