Individual provider Active NPI

Robert Paoletti, D.P.M.

  • Podiatrist
  • Hawthorne, CA
National Provider Identifier
1508902487
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3861 Issued in CA
Practice address
4477 W. 118TH St., Ste 105
Hawthorne, CA 90250
Phone
(310) 679-2251
Fax
(310) 679-9387
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E3861 CA Primary

Addresses

Primary practice location

4477 W. 118TH St., Ste 105
Hawthorne, CA 90250

Mailing address

4477 W. 118TH St., Ste 105
Hawthorne, CA 90250
Phone (310) 679-2251

Other identifiers 2

IdentifierTypeStateIssuer
E3861OtherCALIC
000E38612MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101027000699 CA Practitioner - Podiatry 4981725405 Practice locations: Hawthorne, CA
O20100930083567 CA DME Supplier - Physician - Podiatry 5890816318 Practice locations: Hawthorne, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4477 W 118TH St
Suite 105
Hawthorne, CA 90250-2256
Phone (310) 679-2251

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1650
Removal of nail tissue734
Removal or shaving of skin growth27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E3861CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Openloop Healthcare Partners PC Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508902487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4477 W. 118TH ST., STE 105",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "90250",
            "telephone_number": "310-679-2251",
            "fax_number": "310-679-9387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4477 W. 118TH ST., STE 105",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "90250",
            "telephone_number": "310-679-2251",
            "fax_number": "310-679-9387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAOLETTI",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "E3861",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E38612",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.