NPIMap

Organization Active NPI

Suchir Sheth Podiatry Corporation

  • Podiatrist
  • Santa Monica, CA
National Provider Identifier
1316645351
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
SUCHIR SHETH PODIATRY CORPORATION
Practice address
2001 Santa Monica Blvd Ste 465W
Santa Monica, CA 90404-2178
Phone
(310) 396-5025
Fax
(888) 798-0180
NPI assigned
Feb 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Authorized official

Name
Dr. Suchir Ketan Sheth, DPMNPI 1982050209
Title
President
Phone
(717) 250-9383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

2001 Santa Monica Blvd Ste 465W
Santa Monica, CA 90404-2178

Mailing address

2001 Santa Monica Blvd Ste 465W
Santa Monica, CA 90404-2178
Phone (310) 396-5025

Other identifiers 1

IdentifierTypeStateIssuer
1093262099OtherCAPPO

Other names 1

  • SoCal Sports Podiatry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230823000987 CA Part B Supplier - Clinic/Group Practice 4082077136 Receives reassigned benefits from 5 practitioners
Practice locations: Anaheim, CA; Manhattan Beach, CA; Santa Monica, CA
O20231107002567 CA DME Supplier - Physician - Podiatry 4082077136 Practice locations: Santa Monica, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Suchir Sheth Podiatry Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2001 Santa Monica Blvd
Ste 900W
Santa Monica, CA 90404

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681689600000",
    "number": "1316645351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 465W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042178",
            "telephone_number": "310-396-5025",
            "fax_number": "888-798-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 465W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042178",
            "telephone_number": "310-396-5025",
            "fax_number": "888-798-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUCHIR SHETH PODIATRY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A",
        "authorized_official_last_name": "SHETH",
        "authorized_official_first_name": "SUCHIR",
        "authorized_official_middle_name": "KETAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-250-9383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPO",
            "identifier": "1093262099",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SoCal Sports Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.