Active NPI
Crismali Podiatric Medical Corporation
- Podiatrist
- Hesperia, CA
National Provider Identifier
1407959554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- E3433
- Legal business name
- CRISMALI PODIATRIC MEDICAL CORPORATION
- Practice address
- 18151 Bear Valley Rd
Hesperia, CA 92345-4907 - Phone
- (760) 948-7400
- Fax
- (760) 948-7866
- NPI assigned
- Sep 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Peter Awad, DPM
- Title
- Ceo
- Phone
- (760) 948-7400
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | E3433 | CA | Primary |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | E3433 | CA |
Addresses
Primary practice location
18151 Bear Valley Rd
Hesperia, CA 92345-4907
Mailing address
18151 Bear Valley Rd
Hesperia, CA 92345-4907
Phone (760) 948-7400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ66078Z | Other | BLUE SHIELD |
Other names 1
- Step Forward Foot and Ankle
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060417000781 | CA | Part B Supplier - Clinic/Group Practice | 7012926223 |
Receives reassigned benefits from 4 practitioners Practice locations: Hesperia, CA |
| O20100930033862 | CA | DME Supplier - Physician - Podiatry | 7012926223 | Practice locations: Hesperia, CA |
National Provider Directory
National Provider DirectoryLocations
18151 Bear Valley Rd
Hesperia, CA 92345
Phone (760) 948-7400
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Foot & Ankle Surgery Podiatrist
- Glendora, CA
- NPI 1538884929
CA, Foot & Ankle Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1746144000000",
"number": "1407959554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18151 BEAR VALLEY RD",
"city": "HESPERIA",
"state": "CA",
"postal_code": "923454907",
"telephone_number": "760-948-7400",
"fax_number": "760-948-7866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18151 BEAR VALLEY RD",
"city": "HESPERIA",
"state": "CA",
"postal_code": "923454907",
"telephone_number": "760-948-7400",
"fax_number": "760-948-7866"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CRISMALI PODIATRIC MEDICAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-06",
"last_updated": "2025-05-02",
"certification_date": "2025-05-02",
"status": "A",
"authorized_official_last_name": "AWAD",
"authorized_official_first_name": "PETER",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "760-948-7400",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "CA",
"license": "E3433",
"primary": true
},
{
"code": "213ES0103X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CA",
"license": "E3433",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ66078Z",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Step Forward Foot and Ankle",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Hesperia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.