Anaheim Hills Podiatry Group

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

ANAHEIM HILLS PODIATRY GROUP

Practice address

6200 E Canyon Rim Rd Ste 111E
Anaheim, CA 92807-4313

Phone

(714) 974-3338

Fax

(714) 974-7683

NPI assigned

Oct 24, 2006

Organization subpart

No

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

Authorized official

Name

Lori Preece

Title

Practice Manager

Phone

(714) 974-3338

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Anaheim Hills Podiatry Group Other name

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

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

• Jacob R. Jensen, DPM

  • Foot & Ankle Surgery Podiatrist
  • Anaheim, CA
  • NPI 1215306683

  CA

  Medicare reassignment

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1235213596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 E CANYON RIM RD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074317",
            "telephone_number": "714-974-3338",
            "fax_number": "714-974-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 E CANYON RIM RD STE 111E",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074313",
            "telephone_number": "714-974-3338",
            "fax_number": "714-974-7683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANAHEIM HILLS PODIATRY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "PREECE",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "714-974-3338"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD GRP # - AHPG",
            "identifier": "ZZZ64700Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GRP # -CORONA",
            "identifier": "ZZZ65384Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anaheim Hills Podiatry Group",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Anaheim Hills Podiatry Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Anaheim Hills Family Optometry Inc
• Anaheim Hills Medical Imaging LLC
• Anaheim Hills Medical Pharmacy
• Anaheim Hills Pediatric Dental Practice
• Anaheim Hills Pediatric Therapy Inc.
• Anaheim Hills Psychological Services
• Anaheim Hills Speech & Language Center. Inc.
• Anaheim Hills Speech and Language Center
• Anaheim Hospice, Inc
• Anaheim Injury Center

• All providers in Anaheim, CA
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.