Individual provider Active NPI

Jarrod Matthew Shapiro, DPM

  • Podiatrist
  • Pomona, CA
National Provider Identifier
1316964992
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4884 Issued in CA
Practice address
795 E Second St
Suite 7
Pomona, CA 91766-2007
Phone
(909) 706-3877
Fax
(909) 706-3942
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4884 CA
Podiatrist 213E00000X E4884 CA Primary
Foot Surgery Podiatrist 213ES0131X E4884 CA
Primary Podiatric Medicine Podiatrist 213EP1101X E4884 CA
Radiology Podiatrist 213ER0200X RHD00169584 CA
Sports Medicine Podiatrist 213ES0000X E4884 CA

Addresses

Primary practice location

795 E Second St
Suite 7
Pomona, CA 91766-2007

Mailing address

795 E Second St
Suite 5
Pomona, CA 91766-2007
Phone (909) 706-3877

Other identifiers 2

IdentifierTypeStateIssuer
DL059YOtherCAMEDICARE NO CA PTAN
DL059ZOtherCAMEDICARE PTAN SO CAL

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
I20100903000691 CA Practitioner - Podiatry 3476550195 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empire Foot and Ankle Center IncGroup PAC ID 1254617244, 9 clinicians
Riverside Foot and Ankle Center IncGroup PAC ID 2365839883, 6 clinicians

Practice addresses (Care Compare)

299 W Foothill Blvd
Suite 124
Upland, CA 91786-3854
Phone (909) 946-6643

6216 Brockton Ave
Suite 211
Riverside, CA 92506-2223
Phone (909) 946-6643

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue37
Removal of nail tissue136
Removal or shaving of skin growth53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RHD00169584CAMDRadiology Podiatrist
4884CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Foot and Ankle Center Inc Foot & Ankle Surgery CurrentSince Feb 26, 2024 Accepting new patients
Western University of Health Sciences Podiatrist Current Accepting new patients
Empire Foot and Ankle Center Inc. Foot & Ankle Surgery CurrentSince Jul 1, 2020 Accepting new patients
Yong Luke Lee Medical Corporation Past Accepting new patients
Edward W Sparrow Hospital Association Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Casa Colina Hospital and Centers for Healthcare Past Accepting new patients

Locations

5365 Walnut Ave
Ste M
Chino, CA 91710
Phone (909) 364-1088

795 E 2nd St
Ste 5
Pomona, CA 91766
Phone (909) 706-3877

795 E 2nd St
Ste 8
Pomona, CA 91766
Phone (909) 469-8673

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

8112 Milliken Ave
Ste 101-2
Rch Cucamonga, CA 91730
Phone (909) 706-3950

6216 Brockton Ave
Ste 211
Riverside, CA 92506
Phone (909) 772-4226

3521 Lomita Blvd
Ste 103
Torrance, CA 90505

299 W Foothill Blvd
Ste 124
Upland, CA 91786
Phone (909) 946-6643

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jshapiro148010@direct.ochin.org

Organizations & group practices 7

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486080000000",
    "number": "1316964992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 E SECOND ST",
            "address_2": "SUITE 5",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662007",
            "telephone_number": "909-706-3877",
            "fax_number": "909-706-3942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 E SECOND ST",
            "address_2": "SUITE 7",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662007",
            "telephone_number": "909-706-3877",
            "fax_number": "909-706-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "JARROD",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2017-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4884",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4884",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E4884",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CA",
            "license": "E4884",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "CA",
            "license": "RHD00169584",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "CA",
            "license": "E4884",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NO CA PTAN",
            "identifier": "DL059Y",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN SO CAL",
            "identifier": "DL059Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.