NPIMap

Organization Active NPI

Western Podmed Clinic Inc a Podiatric Corporation

  • Foot & Ankle Surgery Podiatrist
  • Glendale, CA
National Provider Identifier
1184875270
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
WESTERN PODMED CLINIC INC A PODIATRIC CORPORATION
Practice address
1500 S Central Ave
101
Glendale, CA 91204-2530
Phone
(818) 243-0400
Fax
(818) 507-9902
NPI assigned
Oct 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Authorized official

Name
Dr. Martin Moradian, DPMNPI 1780631523
Title
President
Phone
(818) 243-0400

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

1500 S Central Ave
101
Glendale, CA 91204-2530

Mailing address

1500 S Central Ave
101
Glendale, CA 91204-2530
Phone (818) 243-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120516000643 CA DME Supplier - Physician - Podiatry 7517018971 Practice locations: Glendale, CA
O20120926000717 CA Part B Supplier - Clinic/Group Practice 7517018971 Receives reassigned benefits from 4 practitioners
Practice locations: Glendale, CA; Palmdale, CA

National Provider Directory

National Provider Directory

Locations

1500 S Central Ave
Ste 100
Glendale, CA 91204
Phone (818) 242-5299

41210 11th St W
Ste K
Palmdale, CA 93551
Phone (661) 480-0738

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481068800000",
    "number": "1184875270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S CENTRAL AVE",
            "address_2": "101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042530",
            "telephone_number": "818-243-0400",
            "fax_number": "818-507-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S CENTRAL AVE",
            "address_2": "101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042530",
            "telephone_number": "818-243-0400",
            "fax_number": "818-507-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN PODMED CLINIC INC A PODIATRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2016-12-07",
        "status": "A",
        "authorized_official_last_name": "MORADIAN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-243-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.