NPIMap

Organization Active NPI

Bay Area Foot Care, Inc

  • Foot & Ankle Surgery Podiatrist
  • Stockton, CA
National Provider Identifier
1346928009
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
BAY AREA FOOT CARE, INC
Practice address
4722 Quail Lakes Dr Ste a
Stockton, CA 95207-5256
Phone
(209) 476-0675
Fax
(209) 476-9389
NPI assigned
Jul 11, 2023
Organization subpart
Yes
Parent organization
BAY AREA FOOT CARE, INCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Alexander Reyzelman, DPM
Title
Chief Regional Medical Officer
Phone
(415) 292-0638

Corporate family (same tax ID) 46

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

View all 46

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20230801002591 CA DME Supplier - Physician - Podiatry 0345329686 Practice locations: Stockton, CA

National Provider Directory

National Provider Directory
Tax ID family
Bay Area Foot Care Inc (47 organizations share this tax ID)
Part of
Bay Area Foot Care Inc

Specialties & licenses 4

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

NPPES NPI Registry

Primary practice location

4722 Quail Lakes Dr Ste a
Stockton, CA 95207-5256

Mailing address

20130 Lake Chabot Rd Ste 202
Castro Valley, CA 94546-5340
Phone (510) 581-1484

Other names 1

NPPES NPI Registry
  • Bay Area Foot Care Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 1, 2024.

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1346928009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20130 LAKE CHABOT RD STE 202",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465340",
            "telephone_number": "510-581-1484",
            "fax_number": "510-581-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4722 QUAIL LAKES DR STE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075256",
            "telephone_number": "209-476-0675",
            "fax_number": "209-476-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA FOOT CARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAY AREA FOOT CARE, INC",
        "enumeration_date": "2023-07-11",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "REYZELMAN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "CHIEF REGIONAL MEDICAL OFFICER",
        "authorized_official_telephone_number": "415-292-0638",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Area Foot Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bay Area Foot Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.