Pomona Valley Podiatry Group Inc

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E3029 Issued in CA

Legal business name

POMONA VALLEY PODIATRY GROUP INC

Practice address

1212 N Park Ave
Pomona, CA 91768-3029

Phone

(909) 622-4501

Fax

(909) 632-1729

NPI assigned

Jul 30, 2006

Last updated

May 16, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian Frederick Oneill, DPMNPI 1215945647

Title

President

Phone

(909) 622-4501

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian Frederick O'Neill, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Pomona, CA
  • NPI 1215945647
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1518972215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 N PARK AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917683029",
            "telephone_number": "909-622-4501",
            "fax_number": "909-632-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 N PARK AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917683029",
            "telephone_number": "909-622-4501",
            "fax_number": "909-632-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POMONA VALLEY PODIATRY GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "ONEILL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-622-4501",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E302900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pomona Valley Hospital Medical Center
• Pomona Valley Imaging Group (Pomona Valley Hospital Medical Center)
• Pomona Valley Imaging Medical Group Inc
• Pomona Valley Neonatology Medical Group
• Pomona Valley Optometry Inc
• Pomona Valley Rehabilitation Center LLC
• Pomona Valley Specialty Surgery Center, LLC
• Jesse Glenn Pompa
• Doreen Pon, PHARMD
• Brendyn Ponce

• Foot & Ankle Surgery Podiatrist in Pomona, CA
• Providers in Pomona, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.