NPIMap

Organization Active NPI

West Beverly Podiatry Group, Inc

  • Podiatrist
  • Arcadia, CA
National Provider Identifier
1538175997
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
WEST BEVERLY PODIATRY GROUP, INC
Practice address
638 W Duarte Rd Ste 7
Arcadia, CA 91007-9201
Phone
(626) 447-5122
Fax
(626) 447-5272
NPI assigned
Jul 31, 2006
Last updated
Jul 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Authorized official

Name
Mrs. Julie Vega
Title
Manager
Phone
(323) 721-6026

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X CA Primary

Addresses

Primary practice location

638 W Duarte Rd Ste 7
Arcadia, CA 91007-9201

Mailing address

1417 W Beverly Blvd
104
Montebello, CA 90640-4123
Phone (323) 721-6026

Other identifiers 3

IdentifierTypeStateIssuer
480003204OtherCARAILROAD MEDICARE
DA3847OtherCARAILROAD
GRE000310MedicaidCA

Other names 1

  • Arcadia West Beverly Podiatry Group Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324000252 CA Part B Supplier - Clinic/Group Practice 1658262043 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Duarte, CA; Montebello, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Arcadia West Beverly Podiatry Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343001600000",
    "number": "1538175997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 W BEVERLY BLVD",
            "address_2": "104",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404123",
            "telephone_number": "323-721-6026",
            "fax_number": "323-887-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 W DUARTE RD STE 7",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079201",
            "telephone_number": "626-447-5122",
            "fax_number": "626-447-5272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST BEVERLY PODIATRY GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2012-07-23",
        "status": "A",
        "authorized_official_last_name": "VEGA",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "323-721-6026",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480003204",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "DA3847",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GRE000310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arcadia West Beverly Podiatry Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.