Individual provider Active NPI

Lucius Jr Hill Jr., DPM

  • Podiatrist
  • San Bernardino, CA
National Provider Identifier
1013020619
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000E29700 Issued in CA
Practice address
1738 N Waterman Ave
Ste 5
San Bernardino, CA 92404-5131
Phone
(909) 886-7700
Fax
(909) 886-7707
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 000E29700 CA Primary

Addresses

Primary practice location

1738 N Waterman Ave
Ste 5
San Bernardino, CA 92404-5131

Mailing address

1738 N Waterman Ave
Ste 5
San Bernardino, CA 92404-5131
Phone (909) 886-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031230000592 CA Practitioner - Podiatry 7517865348 Reassigns benefits to 1 organization
Practice locations: San Bernardino, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Health Medical GroupGroup PAC ID 4183941222, 4 clinicians

Practice addresses (Care Compare)

1738 N Waterman Ave
Suite 5
San Bernardino, CA 92404-5131
Phone (909) 888-7700

1909 N Waterman Ave
Suite 2
San Bernardino, CA 92404-4842

319 S Brand Blvd
Glendale, CA 91204-1701
Phone (818) 240-0006

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue116
Removal or shaving of skin growth54

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000E29700CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Health Medical Group CurrentSince Jul 31, 2025 Accepting new patients

Locations

319 S Brand Blvd
Glendale, CA 91204
Phone (818) 240-0006

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1013020619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1738 N WATERMAN AVE",
            "address_2": "STE 5",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045131",
            "telephone_number": "909-886-7700",
            "fax_number": "909-886-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1738 N WATERMAN AVE",
            "address_2": "STE 5",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045131",
            "telephone_number": "909-886-7700",
            "fax_number": "909-886-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "LUCIUS",
        "middle_name": "JR",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "000E29700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.