Organization Active NPI

Align Foot and Ankle Center Inc a

  • Foot & Ankle Surgery Podiatrist
  • Camarillo, CA
National Provider Identifier
1073044236
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4368 Issued in CA
Legal business name
ALIGN FOOT AND ANKLE CENTER INC A
Practice address
2460 N Ponderosa Dr
A-105
Camarillo, CA 93010-2398
Phone
(805) 482-0711
Fax
(805) 482-6524
NPI assigned
Mar 21, 2017
Last updated
Sep 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Authorized official

Name
Hai-En Peng, DPM
Title
Owner
Phone
(805) 482-0711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4368 CA Primary

Addresses

Primary practice location

2460 N Ponderosa Dr
A-105
Camarillo, CA 93010-2398

Mailing address

2460 N Ponderosa Dr Ste A105
Camarillo, CA 93010-2375
Phone (805) 482-0711

Other practice location 1

14 E Arrellaga St
Santa Barbara, CA 93101-2502
Phone (805) 965-1515

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170607001624 CA DME Supplier - Physician - Podiatry 0749558146 Practice locations: Camarillo, CA
O20180904003557 CA Part B Supplier - Clinic/Group Practice 0749558146 Receives reassigned benefits from 1 practitioner
Practice locations: Camarillo, CA

National Provider Directory

National Provider Directory

Locations

2460 N Ponderosa Dr
#A10
Camarillo, CA 93010

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1073044236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 N PONDEROSA DR STE A105",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102375",
            "telephone_number": "805-482-0711",
            "fax_number": "805-482-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 N PONDEROSA DR",
            "address_2": "A-105",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102398",
            "telephone_number": "805-482-0711",
            "fax_number": "805-482-6524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 E Arrellaga St",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "931012502",
            "country_code": "US",
            "telephone_number": "805-965-1515",
            "fax_number": "805-482-6524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALIGN FOOT AND ANKLE CENTER INC A",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-21",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "PENG",
        "authorized_official_first_name": "HAI-EN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-482-0711",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.