Individual provider Active NPI

Pete Carrasco Jr., D.P.M.

  • Podiatrist
  • Rancho Cucamonga, CA
National Provider Identifier
1073573127
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E-3608 Issued in CA
Practice address
7196 Sunnyside PL
Rancho Cucamonga, CA 91739-5995
Phone
(951) 212-6661
Fax
(909) 987-3292
NPI assigned
Mar 24, 2006
Last updated
Mar 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E-3608 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
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
I20050228000518 CA Practitioner - Podiatry 7315990553 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
78.03 of 100Reported as group
Quality
78.11
Improvement activities
40
Cost
33.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
E-3608CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Carrasco Podiatry Corporation Podiatrist CurrentSince Jan 1, 2000 Accepting new patients
Wound Healing Care Specialists, Inc. Podiatrist CurrentSince Oct 20, 2018 Accepting new patients
Foothills Psychological Services, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Providence Podiatry Care, Inc CurrentSince Oct 29, 2021 Accepting new patients
Rancho Wound Care Center, PC Podiatrist CurrentSince Apr 9, 2025 Accepting new patients
Mission City Community Network, Inc. CurrentSince Jul 7, 2025 Accepting new patients
Mission City Community Network, Inc. CurrentSince Jul 7, 2025 Accepting new patients
Wound Healing Care Specialists TN PC PastSince Jan 21, 2025 Accepting new patients
Wound Healing Care Specialists KS Inc PastSince Aug 6, 2025 Accepting new patients
Convalescent Podiatry Care Podiatrist Past Accepting new patients
James F Eggold Podiatrist Past Accepting new patients
Wound Healing Care Specialists Wa PC PastSince Aug 26, 2025 Accepting new patients

Locations

8363 Reseda Blvd
Ste 11
Northridge, CA 91324
Phone (818) 882-0009

3536 Concours
Ste 225
Ontario, CA 91764
Phone (314) 699-9181

1550 N Park Ave
Pomona, CA 91768
Phone (909) 623-0791

10621 Church St
Ste 120
Rch Cucamonga, CA 91730
Phone (909) 944-0481

11343 Base Line Rd
Rch Cucamonga, CA 91730

25044 Peachland Ave
Ste 110
Santa Clarita, CA 91321

15206 Parthenia St
Sepulveda, CA 91343

473 E Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

954 W Foothill Blvd
Ste A
Upland, CA 91786
Phone (909) 946-4222

15201 Eleventh St
Ste 300
Victorville, CA 92395
Phone (760) 245-1640

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426723200000",
    "number": "1073573127",
    "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": "909-899-0258"
        },
        {
            "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": {
        "last_name": "CARRASCO",
        "first_name": "PETE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2015-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E-3608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.