Individual provider Active NPI

Michael Paul Fishman, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Los Alamitos, CA
National Provider Identifier
1366764763
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E-4874 Issued in CA
Practice address
3851 Katella Ave
Suite # 255
Los Alamitos, CA 90720-3377
Phone
(562) 431-2558
Fax
(562) 296-8389
NPI assigned
Feb 26, 2010
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E-4874 CA Primary

Addresses

Primary practice location

3851 Katella Ave
Suite # 255
Los Alamitos, CA 90720-3377

Mailing address

3851 Katella Ave
Suite # 255
Los Alamitos, CA 90720-3377
Phone (562) 431-2558

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
I20100922000750 CA Practitioner - Podiatry 4587780069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3851 Katella Ave
Suite 255
Los Alamitos, CA 90720-3353
Phone (562) 431-2558

Hospital & facility affiliations

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 tissue183
Removal of skin lesions668
Removal of nail tissue1183
Removal or shaving of skin growth115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E-4874CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Fishman DPM Inc Foot & Ankle Surgery CurrentSince Aug 18, 2014 Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients

Locations

3851 Katella Ave
Ste 255
Los Alamitos, CA 90720
Phone (562) 431-2558

3851 Katella Ave
Ste 355
Los Alamitos, CA 90720
Phone (562) 264-5154

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: drfootman@mfd-ca.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1366764763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 KATELLA AVE",
            "address_2": "SUITE # 255",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203377",
            "telephone_number": "562-431-2558",
            "fax_number": "562-296-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 KATELLA AVE",
            "address_2": "SUITE # 255",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203377",
            "telephone_number": "562-431-2558",
            "fax_number": "562-296-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHMAN",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-26",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E-4874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.