Individual provider Active NPI

Shun Sophia Lu, DPM

  • Podiatrist
  • Hacienda Heights, CA
National Provider Identifier
1295099356
Registry record updated Feb 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E5162 Issued in CA
Practice address
1850 S Azusa Ave.
Suite #306
Hacienda Heights, CA 91745-6854
Phone
(626) 824-9772
NPI assigned
Jul 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E5162 CA Primary

Addresses

Primary practice location

1850 S Azusa Ave.
Suite #306
Hacienda Heights, CA 91745-6854

Mailing address

1850 S Azusa Ave.
Suite #306
Hacienda Heights, CA 91745-6854
Phone (626) 824-9772

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
I20150923002885 CA Practitioner - Podiatry 8224345293 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot Heel Ankle Podiatry CorporationGroup PAC ID 7719235159, 2 clinicians

Practice addresses (Care Compare)

1850 S Azusa Ave
Suite 306
Hacienda Heights, CA 91745-6854
Phone (909) 623-4484

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue516
Removal or shaving of skin growth314

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5162CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Heel Ankle Podiatry Corporation Podiatrist CurrentSince Jun 7, 2018 Accepting new patients
Scosi Orthopedics Inc CurrentSince Sep 1, 2015 Accepting new patients
Moellmer, Inc. Past Accepting new patients

Locations

18575 Gale Ave
Ste 278
City of Industry, CA 91748
Phone (626) 559-5181

1850 S Azusa Ave
Ste 306
Hacienda Hts, CA 91745
Phone (626) 824-9772

1520 N Mountain Ave
#E122
Ontario, CA 91762
Phone (714) 696-8746

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.

NPI Registry JSON

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455840000000",
    "number": "1295099356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 S AZUSA AVE.",
            "address_2": "SUITE #306",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917456854",
            "telephone_number": "626-824-9772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 S AZUSA AVE.",
            "address_2": "SUITE #306",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917456854",
            "telephone_number": "626-824-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "SHUN",
        "middle_name": "SOPHIA",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2016-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hacienda Heights, CA

Sources for this page

Verify at the official NPI Registry.