Individual provider Active NPI

Jonathan Pirak, DPM

  • Podiatrist
  • Los Angeles, CA
National Provider Identifier
1528598133
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E5476 Issued in CA
Practice address
1420 Ambassador St Apt 304
Los Angeles, CA 90035-2857
Phone
(201) 563-2937
NPI assigned
Jun 15, 2017
Last updated
Nov 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E5476 CA Primary

Addresses

Primary practice location

1420 Ambassador St Apt 304
Los Angeles, CA 90035-2857

Mailing address

1420 Ambassador St Apt 304
Los Angeles, CA 90035-2857

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
I20191014002313 CA Practitioner - Podiatry 7911238449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Prime Podiatric Group, IncGroup PAC ID 1658711783, 3 clinicians

Practice addresses (Care Compare)

10916 Riverside Dr
Toluca Lake, CA 91602-2210
Phone (818) 488-6076

12826 Victory Blvd
North Hollywood, CA 91606-3065
Phone (310) 499-8676

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue5061
Removal or shaving of skin growth4949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5476CAMDOptometrist
E5476CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael D. Kotzen, Inc. Single Specialty CurrentSince Sep 13, 2020 Accepting new patients
Regel Foot and Ankle Associates Incorporated Single Specialty CurrentSince Sep 19, 2019 Accepting new patients
Prime Podiatric Group, Inc Single Specialty CurrentSince Jan 24, 2024 Accepting new patients

Locations

3126 S Sepulveda Blvd
Los Angeles, CA 90034

12826 Victory Blvd
North Hollywood, CA 91606
Phone (310) 499-8676

10916 Riverside Dr
Toluca Lake, CA 91602
Phone (818) 210-0281

12520 Magnolia Blvd
Ste 304
Valley Vlg, CA 91607
Phone (818) 452-9902

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, 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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1528598133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 AMBASSADOR ST APT 304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900352857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 AMBASSADOR ST APT 304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900352857",
            "telephone_number": "201-563-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIRAK",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-15",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.