Individual provider Active NPI

Roger Yoriki Tsutsumi, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Riverside, CA
National Provider Identifier
1104816230
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4188 Issued in CA
Practice address
7111 Magnolia Ave Ste 100
Riverside, CA 92504-3842
Phone
(951) 359-8802
Fax
(951) 359-8802
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4188 CA Primary

Addresses

Primary practice location

7111 Magnolia Ave Ste 100
Riverside, CA 92504-3842

Mailing address

7111 Magnolia Ave Ste 100
Riverside, CA 92504-3842
Phone (951) 359-8800

Other practice location 1

124 W 9th St
Corona, CA 92882-3320
Phone (951) 898-8700

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
I20100624000361 CA Practitioner - Podiatry 0749311454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

124 W 9TH St
Corona, CA 92882-3320
Phone (951) 898-8700

7111 Magnolia Ave
Suite 100
Riverside, CA 92504-3842

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1045
Removal of nail tissue3355
Removal or shaving of skin growth1751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4188CAMDFoot & Ankle Surgery Podiatrist
4188CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Roger Tsutsumi DPM Inc Foot & Ankle Surgery CurrentSince Nov 21, 2013 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
James a. de Silva, D.P.M., Inc. Foot & Ankle Surgery Past Accepting new patients
James a. de Silva, DPM, Inc. Foot & Ankle Surgery Past Accepting new patients
Uhs Corona Inc Past Accepting new patients

Locations

124 W 9th St
Corona, CA 92882
Phone (951) 582-9627

7111 Magnolia Ave
Ste 100
Riverside, CA 92504
Phone (951) 359-8800

9041 Magnolia Ave
Ste 203
Riverside, CA 92503
Phone (951) 688-0361

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1104816230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 MAGNOLIA AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925043842",
            "telephone_number": "951-359-8800",
            "fax_number": "951-359-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 MAGNOLIA AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925043842",
            "telephone_number": "951-359-8802",
            "fax_number": "951-359-8802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 W 9th St",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928823320",
            "country_code": "US",
            "telephone_number": "951-898-8700",
            "fax_number": "951-898-8733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TSUTSUMI",
        "first_name": "ROGER",
        "middle_name": "YORIKI",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.