Individual provider Active NPI

Gregory Kirk Eirich, DPM, FACFAS

  • Podiatrist
  • Tustin, CA
National Provider Identifier
1245220649
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3763 Issued in CA
Practice address
13362 Newport Ave Ste a
Tustin, CA 92780-3427
Phone
(714) 669-1780
Fax
(714) 669-1488
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E3763 CA Primary

Addresses

Primary practice location

13362 Newport Ave Ste a
Tustin, CA 92780-3427

Mailing address

13362 Newport Ave Ste a
Tustin, CA 92780-3427
Phone (714) 669-1780

Other identifiers 2

IdentifierTypeStateIssuer
000E37630MedicaidCA
1245220649MedicaidCA

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
I20050630000177 CA Practitioner - Podiatry 9335185388 Practice locations: Tustin, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

661 W 1St St
Suite D
Tustin, CA 92780-2939
Phone (714) 669-1780

661 W 1St St D
Tustin, CA 92780-2939

Hospital & facility affiliations

  • Onoria Health Care Provider Inc Home Health and Ho Home health agency, Montclair, CA, CCN 059482

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue260
Removal of skin lesions1-10
Removal of nail tissue200
Removal or shaving of skin growth279

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E3763CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Ana Tustin Podiatry Corporation Podiatrist PastSince Aug 29, 2021 Accepting new patients

Organizations & group practices 1

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 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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1245220649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13362 NEWPORT AVE STE A",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803427",
            "telephone_number": "714-669-1780",
            "fax_number": "714-669-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13362 NEWPORT AVE STE A",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803427",
            "telephone_number": "714-669-1780",
            "fax_number": "714-669-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIRICH",
        "first_name": "GREGORY",
        "middle_name": "KIRK",
        "credential": "DPM, FACFAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E37630",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245220649",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.