Organization Active NPI

Crismali Podiatric Medical Corporation

  • Podiatrist
  • Hesperia, CA
National Provider Identifier
1407959554
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3433 Issued in CA
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

Updated by the provider on May 2, 2025

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

Authorized official

Name
Peter Awad, DPMNPI 1679837108
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)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X E3433 CA Primary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
ZZZ66078ZOtherBLUE SHIELD

Other names 1

  • Step Forward Foot and Ankle Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 Directory

Locations

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.

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.

Verify at the official NPI Registry.