Individual provider Active NPI

Michael Blake Runyon, DPM

  • Foot Surgery Podiatrist
  • Van Nuys, CA
National Provider Identifier
1225006950
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
E1908 Issued in CA
Practice address
13701 Burbank Blvd
Van Nuys, CA 91401-5040
Phone
(818) 997-1216
Fax
(818) 997-4458
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X E1908 CA Primary

Addresses

Primary practice location

13701 Burbank Blvd
Van Nuys, CA 91401-5040

Mailing address

13701 Burbank Blvd
Van Nuys, CA 91401-5040
Phone (818) 997-1216

Other identifiers 1

IdentifierTypeStateIssuer
E1908OtherCACALIFORNIA STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
E1908CAMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Carewell Med Supply PastSince Apr 27, 2025 Accepting new patients
Tae Hyun Kim DPM Inc Past Accepting new patients

Organizations & group practices 2

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1225006950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13701 BURBANK BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914015040",
            "telephone_number": "818-997-1216",
            "fax_number": "818-997-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13701 BURBANK BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914015040",
            "telephone_number": "818-997-1216",
            "fax_number": "818-997-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNYON",
        "first_name": "MICHAEL",
        "middle_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E1908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE LICENSE",
            "identifier": "E1908",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.