Individual provider Active NPI

Nathaniel D Witmer, D.P.M.

  • Podiatrist
  • Valencia, CA
National Provider Identifier
1497172712
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E5395 Issued in CA
Practice address
23803 McBean Pkwy
Valencia, CA 91355-2001
Phone
(661) 481-2400
NPI assigned
Mar 25, 2014
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Podiatrist 213E00000X E5395 CA Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 016.005661 IL

Addresses

Primary practice location

23803 McBean Pkwy
Valencia, CA 91355-2001

Mailing address

PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5559

Other practice location 1

2900 N Lake Shore Dr
Chicago, IL 60657-5640
Phone (773) 665-3000

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
I20180205002894 CA Practitioner - Podiatry 3173821113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

23803 McBean Pkwy
Suite 201
Valencia, CA 91355-4462
Phone (661) 481-2400

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue13
Removal of skin lesions1-10
Removal of nail tissue205
Removal or shaving of skin growth42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5395CAMDPodiatrist
016.005661ILMDFoot & Ankle Surgery Podiatrist
5395CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince Feb 5, 2018 Accepting new patients
Providence Facey Medical Foundation CurrentSince Feb 5, 2018 Accepting new patients

Locations

File 50670
Los Angeles, CA 90074

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

23803 McBean Pkwy
Ste 201
Valencia, CA 91355
Phone (661) 481-2400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: nwitmer856281@oc.providencedirect.org

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

NPI Registry JSON

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1497172712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5559",
            "fax_number": "818-792-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23803 MCBEAN PKWY",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552001",
            "telephone_number": "661-481-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 N Lake Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575640",
            "country_code": "US",
            "telephone_number": "773-665-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITMER",
        "first_name": "NATHANIEL",
        "middle_name": "D",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5395",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016.005661",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.