NPIMap

Organization Active NPI

University Foot and Ankle Institute a Podiatric Surgical Center

  • Podiatrist
  • Manhattan Beach, CA
National Provider Identifier
1083721054
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4186 Issued in CA
Legal business name
UNIVERSITY FOOT AND ANKLE INSTITUTE A PODIATRIC SURGICAL CENTER
Practice address
1101 Sepulveda Blvd
Suite 104
Manhattan Beach, CA 90266
Phone
(310) 828-0011
Fax
(310) 828-2001
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Mr. Babak Baravarian, DPMNPI 1952310799
Title
Partner Podiatry
Phone
(310) 828-0011

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X E4186 CA Primary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X E3141 CA
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X E4693 CA

Addresses

Primary practice location

1101 Sepulveda Blvd
Suite 104
Manhattan Beach, CA 90266

Mailing address

2121 Wilshire Blvd
Suite 101
Santa Monica, CA 90403
Phone (310) 828-0011

Other identifiers 1

IdentifierTypeStateIssuer
1114147444OtherCANPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318000895 CA Part B Supplier - Clinic/Group Practice 3971493347 Receives reassigned benefits from 26 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Monica, CA; Westlake Village, CA; Valencia, CA; Torrance, CA; Sherman Oaks, CA; Santa Barbara, CA; San Pedro, CA; Northridge, CA…

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1245 Wilshire Blvd
Ste 110
Los Angeles, CA 90017

3984 S Figueroa St
Los Angeles, CA 90037
Phone (213) 747-7272

1101 N Sepulveda Blvd
Ste 101
Manhattan Beach, CA 90266

1360 W 6th St
Ste 240W
San Pedro, CA 90732

2121 Wilshire Blvd
Ste 100
Santa Monica, CA 90403

5170 Sepulveda Blvd
Ste 100
Sherman Oaks, CA 91403
Phone (310) 297-9221

2941 Cochran St
Ste 5
Simi Valley, CA 93065
Phone (805) 583-3028

26357 McBean Pkwy
Ste 240
Valencia, CA 91355
Phone (661) 259-8755

23861 McBean Pkwy
Ste C6
Valencia, CA 91355
Phone (661) 222-7822

1220 La Venta Dr
Ste 203
Westlake Vlg, CA 91361
Phone (805) 497-8100

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1083721054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 WILSHIRE BLVD",
            "address_2": "SUITE 101",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90403",
            "telephone_number": "310-828-0011",
            "fax_number": "310-828-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SEPULVEDA BLVD",
            "address_2": "SUITE 104",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "90266",
            "telephone_number": "310-828-0011",
            "fax_number": "310-828-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY FOOT AND ANKLE INSTITUTE A PODIATRIC SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "BARAVARIAN",
        "authorized_official_first_name": "BABAK",
        "authorized_official_title_or_position": "PARTNER  PODIATRY",
        "authorized_official_telephone_number": "310-828-0011",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4186",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3141",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4693",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1114147444",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.