Individual provider Active NPI

Suzanne Lee Mancherian, DPM

  • Podiatrist
  • Los Angeles, CA
National Provider Identifier
1427129741
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4429 Issued in CA
Practice address
6200 Wilshire Blvd Ste 1712
Los Angeles, CA 90048
Phone
(323) 937-6903
Fax
(323) 210-7171
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4429 CA Primary

Addresses

Primary practice location

6200 Wilshire Blvd Ste 1712
Los Angeles, CA 90048

Mailing address

585 S Fairfax Ave
Los Angeles, CA 90036-2035
Phone (323) 937-6903

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
I20051222000550 CA Practitioner - Podiatry 5799707352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6310 San Vicente Blvd
Suite 220
Los Angeles, CA 90048-5458
Phone (323) 937-6903

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue33
Removal of skin lesions1-10
Removal of nail tissue975
Removal or shaving of skin growth2369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4429CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Wellness Clinic Current Accepting new patients
Foot and Ankle Wellness Clinic Podiatrist CurrentSince Jul 11, 2002 Accepting new patients

Locations

1030 S Glendale Ave
Ste 504
Glendale, CA 91205
Phone (818) 240-7673

6200 Wilshire Blvd
Ste 1712
Los Angeles, CA 90048
Phone (323) 937-6903

6310 San Vicente Blvd
Ste 220
Los Angeles, CA 90048
Phone (310) 274-9977

585 S Fairfax Ave
Los Angeles, CA 90036
Phone (323) 937-6903

Organizations & group practices 2

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1427129741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 S FAIRFAX AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900362035",
            "telephone_number": "323-937-6903",
            "fax_number": "323-937-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD STE 1712",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90048",
            "telephone_number": "323-937-6903",
            "fax_number": "323-210-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCHERIAN",
        "first_name": "SUZANNE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.