Individual provider Active NPI

Salem Lebada, DPM

  • Foot & Ankle Surgery Podiatrist
  • Los Angeles, CA
National Provider Identifier
1124694625
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E6020 Issued in CA
Practice address
505 S Virgil Ave Ste 205
Los Angeles, CA 90020-1443
Phone
(213) 805-5822
NPI assigned
Jun 3, 2021
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 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 E6020 CA Primary

Addresses

Primary practice location

505 S Virgil Ave Ste 205
Los Angeles, CA 90020-1443

Mailing address

505 S Virgil Ave Ste 205
Los Angeles, CA 90020-1443
Phone (213) 805-5822

Other practice location 1

638 West Commonwealth Ave
Fullerton, CA 92832
Phone (213) 805-5822

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
I20240910000830 CA Practitioner - Podiatry 0648710285 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Western Un of HLTH Sciences, Col of Podiatric Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Han Orthopaedics IncGroup PAC ID 1153647433, 4 clinicians
MRR Foot and Ankle IncGroup PAC ID 0244647360, 3 clinicians

Practice addresses (Care Compare)

505 S Virgil Ave
Suite 205
Los Angeles, CA 90020-1443
Phone (213) 805-5822

5115 Clareton Dr
Suite 135
Agoura Hills, CA 91301-6317
Phone (213) 373-3246

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue46
Removal or shaving of skin growth34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E6020CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Han Orthopaedics Inc CurrentSince Sep 1, 2024 Accepting new patients
MRR Foot & Ankle Inc Foot & Ankle Surgery CurrentSince Sep 1, 2024 Accepting new patients
White Memorial Medical Center PastSince Sep 1, 2024 Accepting new patients

Locations

5115 Clareton Dr
Ste 135
Agoura Hills, CA 91301
Phone (213) 373-3246

500 E Olive Ave
Ste 840
Burbank, CA 91501
Phone (213) 373-3246

638 W Commonwealth Ave
Fullerton, CA 92832
Phone (213) 805-5822

6444 San Fernando
Unit 5611
Glendale, CA 91221

505 S Virgil Ave
Ste 205
Los Angeles, CA 90020
Phone (213) 380-0401

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DACIDD/Endpoint/DACIDD
  • Direct secure messaging: salem.lebada.1@27758.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1124694625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S VIRGIL AVE STE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201443",
            "telephone_number": "213-805-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S VIRGIL AVE STE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201443",
            "telephone_number": "213-805-5822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "638 West Commonwealth Ave",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "92832",
            "country_code": "US",
            "telephone_number": "213-805-5822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEBADA",
        "first_name": "SALEM",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-03",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E6020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.