NPIMap

Organization Active NPI

Carrasco Podiatry Corporation

  • Podiatrist
  • Rancho Cucamonga, CA
National Provider Identifier
1043339260
Registry record updated Nov 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3608 Issued in CA
Legal business name
CARRASCO PODIATRY CORPORATION
Practice address
7196 Sunnyside PL
Rancho Cucamonga, CA 91739-5995
Phone
(951) 212-6661
Fax
(909) 987-3292
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2012

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

Authorized official

Name
Dr. Pete Carrasco Jr., D.P.M.NPI 1073573127
Title
Doctor of Podiatric Medicine
Phone
(951) 212-6661

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X E3608 CA Primary

Addresses

Primary practice location

7196 Sunnyside PL
Rancho Cucamonga, CA 91739-5995

Mailing address

PO Box 4347
Rancho Cucamonga, CA 91729-4347
Phone (951) 212-6661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050712000777 CA Part B Supplier - Clinic/Group Practice 2365478245 Receives reassigned benefits from 23 practitioners
Practice locations: San Gabriel, CA; Rancho Cucamonga, CA

National Provider Directory

National Provider Directory

Locations

25271 Barton Rd
Loma Linda, CA 92354
Phone (909) 796-0216

Practitioners & affiliated clinicians

Practitioners 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352592000000",
    "number": "1043339260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4347",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917294347",
            "telephone_number": "951-212-6661",
            "fax_number": "909-987-3292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7196 SUNNYSIDE PL",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917395995",
            "telephone_number": "951-212-6661",
            "fax_number": "909-987-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARRASCO PODIATRY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2012-11-11",
        "status": "A",
        "authorized_official_last_name": "CARRASCO",
        "authorized_official_first_name": "PETE",
        "authorized_official_title_or_position": "DOCTOR OF PODIATRIC MEDICINE",
        "authorized_official_telephone_number": "951-212-6661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.