Individual provider Active NPI

Sam Nosrati, DPM

  • Foot & Ankle Surgery Podiatrist
  • Mission Viejo, CA
National Provider Identifier
1164795209
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4997 Issued in CA
Practice address
26800 Crown Valley Pkwy Ste 420
Mission Viejo, CA 92691-8023
Phone
(949) 272-0007
Fax
(949) 272-0006
NPI assigned
Feb 21, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2019

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 E4997 CA Primary

Addresses

Primary practice location

26800 Crown Valley Pkwy Ste 420
Mission Viejo, CA 92691-8023

Mailing address

32565 B Golden Lantern Street
PMB 341
Dana Point, CA 92629-3261
Phone (949) 272-0007

Other practice location 1

23141 Moulton Pkwy Ste 109
Laguna Hills, CA 92653-1241
Phone (949) 272-0007

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
I20120724000413 CA Practitioner - Podiatry 6608032446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Artisan Foot and Ankle Podiatric Specialists IncGroup PAC ID 9234254061, 10 clinicians

Practice addresses (Care Compare)

1501 Westcliff Dr
Suite 300
Newport Beach, CA 92660-5504
Phone (949) 272-0007

23141 Moulton Pkwy
Suite 109
Laguna Woods, CA 92653-1241
Phone (919) 272-0007

655 Camino de Los Mares
Suite 120
San Clemente, CA 92673-2809
Phone (949) 272-0007

Hospital & facility affiliations

  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

Merit-based Incentive Payment System (MIPS)

Final score
97.42 of 100Reported as individual
Quality
84.86
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue199
Removal of skin lesions28
Removal of nail tissue436
Removal or shaving of skin growth440
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4997CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Saddleback Memorial Medical Center Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1164795209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32565 B GOLDEN LANTERN STREET",
            "address_2": "PMB 341",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926293261",
            "telephone_number": "949-272-0007",
            "fax_number": "949-272-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY STE 420",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918023",
            "telephone_number": "949-272-0007",
            "fax_number": "949-272-0006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23141 Moulton Pkwy Ste 109",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "926531241",
            "country_code": "US",
            "telephone_number": "949-272-0007",
            "fax_number": "949-272-0006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOSRATI",
        "first_name": "SAM",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-21",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.