Individual provider Active NPI

Daisy Wu, DPM

  • Podiatrist
  • Riverside, CA
National Provider Identifier
1366406381
Registry record updated Mar 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4404 Issued in CA
Practice address
4646 Brockton Ave Ste 202
Riverside, CA 92506-0103
Phone
(951) 751-9096
Fax
(951) 848-9163
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4404 CA Primary

Addresses

Primary practice location

4646 Brockton Ave Ste 202
Riverside, CA 92506-0103

Mailing address

PO Box 80362
Rancho Santa Margarita, CA 92688-0362
Phone (951) 751-9096

Other identifiers 4

IdentifierTypeStateIssuer
000E44040MedicaidCA
P00317457OtherRAILROAD MEDICARE
E44040OtherCACA LICENSE
U91569OtherCAUPIN

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
I20031217000778 CA Practitioner - Podiatry 1951208941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4646 Brockton Ave
Suite 202
Riverside, CA 92506-0104
Phone (951) 751-9096

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1450
Removal or shaving of skin growth318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Daisy Wu, DPM, Inc. Podiatrist CurrentSince May 24, 2010 Accepting new patients
Housecall Doctors Medical Group Inc Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients

Locations

4646 Brockton Ave
Ste 202
Riverside, CA 92506
Phone (909) 774-2800

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269561600000",
    "number": "1366406381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80362",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926880362",
            "telephone_number": "951-751-9096",
            "fax_number": "951-848-9163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 BROCKTON AVE STE 202",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925060103",
            "telephone_number": "951-751-9096",
            "fax_number": "951-848-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "DAISY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2010-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E44040",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00317457",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE",
            "identifier": "E44040",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "U91569",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.