Individual provider Active NPI

Christopher Mark Arismendi, MD

  • Surgery Physician
  • Stockton, CA
National Provider Identifier
1396792339
Registry record updated Jun 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G73525 Issued in CA
Practice address
420 W Acacia St
Stockton, CA 95203-2441
Phone
(209) 466-9694
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G73525 CA Primary

Addresses

Primary practice location

420 W Acacia St
Stockton, CA 95203-2441

Mailing address

4347 Portage St NW Ste 102
North Canton, OH 44720-7371
Phone (800) 527-0336

Other identifiers 2

IdentifierTypeStateIssuer
G73525OtherCAMEDICAL LICENSE
00G735250MedicaidCA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050502001294 CA Practitioner - General SurgeryPractitioner - Vascular Surgery 7214976919 Practice locations: Stockton, CA

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
St. Louis College of Physicians and Surgeons, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

420 W Acacia St
Suite 3
Stockton, CA 95203-6969
Phone (209) 466-9694

525 W Acacia St
Stockton, CA 95203-2405
Phone (209) 944-5550

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Coronary artery bypass graft (CABG)103
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G73525CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dameron Hospital Association PastSince Mar 1, 1994 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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.

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1396792339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4347 PORTAGE ST NW STE 102",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207371",
            "telephone_number": "800-527-0336",
            "fax_number": "330-244-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W ACACIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952032441",
            "telephone_number": "209-466-9694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARISMENDI",
        "first_name": "CHRISTOPHER",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G73525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G73525",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G735250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.