Active NPI
Dhaval I Patel, D.P.M
- Foot & Ankle Surgery Podiatrist
- Upland, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- E5573
- Practice address
- 984 W Foothill Blvd Ste B
Upland, CA 91786-3787 - Phone
- (909) 920-0884
- NPI assigned
- Jun 24, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Foot & Ankle Surgery Podiatrist | 213ES0103X | E5573 | CA | Primary |
| Podiatrist | 213E00000X | E5573 | CA |
Addresses
Primary practice location
984 W Foothill Blvd Ste B
Upland, CA 91786-3787
Mailing address
10112 Foothill Blvd Unit 255
Rancho Cucamonga, CA 91730-0377
Phone (917) 774-6768
Other practice location 1
10112 Foothill Blvd Unit 255
Rancho Cucamonga, CA 91730-0377
Phone (917) 774-6768
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5573 | CA | MD | Clinical Social Worker |
| E5573 | CA | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jan David Tepper, DPM, Inc | Foot & Ankle Surgery | Current | Accepting new patients |
| Wound Care Center of Socal PC | Foot & Ankle Surgery | Current | Accepting new patients |
Locations
984 W Foothill Blvd
Ste B
Upland, CA 91786
Phone (909) 920-0884
984 W Foothill Blvd
Ste A
Upland, CA 91786
Phone (909) 920-0884
Interoperability endpoints
- dpatel@jdtdpm.emadirect.md
Organizations & group practices 3
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.
-
- Foot & Ankle Surgery Podiatrist
- Upland, CA
- NPI 1083426274
-
dba Family Foot and Ankle Center
- Non-Pharmacy Dispensing Site
- Upland, CA
- NPI 1932465978
Foot & Ankle Surgery
-
- Foot & Ankle Surgery Podiatrist
- Upland, CA
- NPI 1851328744
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737072000000",
"number": "1508152851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10112 FOOTHILL BLVD UNIT 255",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917300377",
"telephone_number": "917-774-6768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "984 W FOOTHILL BLVD STE B",
"city": "UPLAND",
"state": "CA",
"postal_code": "917863787",
"telephone_number": "909-920-0884"
}
],
"practiceLocations": [
{
"address_1": "10112 Foothill Blvd Unit 255",
"address_purpose": "LOCATION",
"city": "Rancho Cucamonga",
"state": "CA",
"postal_code": "917300377",
"country_code": "US",
"telephone_number": "917-774-6768",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATEL",
"first_name": "DHAVAL",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "D.P.M",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-24",
"last_updated": "2025-01-17",
"certification_date": "2025-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CA",
"license": "E5573",
"primary": true
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "CA",
"license": "E5573",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.