Active NPI
Joseph Park, DPM
- Foot & Ankle Surgery Podiatrist
- Pomona, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- E5726
- Practice address
- 309 E 2ND St
Pomona, CA 91766-1854 - Phone
- (909) 623-6116
- NPI assigned
- Apr 2, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | E5726 | CA | Primary |
Addresses
Primary practice location
309 E 2ND St
Pomona, CA 91766-1854
Mailing address
309 E 2ND St
Pomona, CA 91766-1854
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- New York College of Podiatric Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
26600 Cactus Ave
FL 2
Moreno Valley, CA 92555-3901
Phone (951) 486-4000
795 E 2ND St
Suite 7
Pomona, CA 91766-2007
Phone (909) 469-8673
Hospital & facility affiliations
- Riverside University Health System-Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.49 of 100
- Quality
- 68.78
- Improvement activities
- 40
- Cost
- 78.85
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 15 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 13 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007034 | NY | MD | Clinical Psychologist |
| E5726 | CA | MD | Foot & Ankle Surgery Podiatrist |
Practice roles (6 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| De Anza Orthopedic Medical Group, Inc. | Current | Accepting new patients | |
| The Southeast Permanente Medical Group | Current | Accepting new patients | |
| Western University of Health Sciences | Current | Accepting new patients | |
| Western University of Health Sciences | Current | Accepting new patients | |
| Western University of Health Sciences | Foot & Ankle Surgery | Current | Accepting new patients |
| Mark Brian Friedman, DPM, PLLC | Past | Accepting new patients |
Locations
26600 Cactus Ave
Fl 2
Moreno Valley, CA 92555
26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610
795 E 2nd St
Ste 2
Pomona, CA 91766
Phone (909) 469-8673
309 E 2nd St
Pomona, CA 91766
Phone (909) 469-5589
795 E 2nd St
Ste 8
Pomona, CA 91766
Phone (909) 469-8673
795 E 2nd St
Ste 5
Pomona, CA 91766
Phone (909) 706-3877
795 E 2nd St
Ste 7
Pomona, CA 91766
Phone (909) 469-8673
8686 Haven Ave
Ste 200
Rancho Cucamonga, CA 91730
Phone (909) 706-3950
3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000
20 Glenlake Pkwy
Sandy Springs, GA 30328
Phone (770) 677-6247
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- jpark417961@direct.llu.edu
Organizations & group practices 6
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.
-
- Orthopaedic Surgery Physician
- Moreno Valley, CA
- NPI 1255762340
-
- Family Medicine Physician
- Pomona, CA
- NPI 1679515217
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1245266956
-
- Pharmacy
- Pomona, CA
- NPI 1295051779
-
- Podiatrist
- Albany, NY
- NPI 1225540248
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Moreno Valley, CA
- NPI 1821159195
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636070400000",
"number": "1306231600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 E 2ND ST",
"city": "POMONA",
"state": "CA",
"postal_code": "917661854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 E 2ND ST",
"city": "POMONA",
"state": "CA",
"postal_code": "917661854",
"telephone_number": "909-623-6116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-02",
"last_updated": "2021-11-05",
"certification_date": "2021-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CA",
"license": "E5726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.