Active NPI
Michael Digiacomo, DPM
- Foot & Ankle Surgery Podiatrist
- Oakland, CA
National Provider Identifier
1558377465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- E1909
- Practice address
- 445 30TH St
Oakland, CA 94609-3301 - Phone
- (510) 465-8012
- Fax
- (510) 835-1626
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | E1909 | CA | Primary |
Addresses
Primary practice location
445 30TH St
Oakland, CA 94609-3301
Mailing address
445 30TH St
Oakland, CA 94609-3301
Phone (510) 465-8012
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000E19090 | Other | CA | MEDI-CAL PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E1909 | CA | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449446400000",
"number": "1558377465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 30TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093301",
"telephone_number": "510-465-8012",
"fax_number": "510-835-1626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 30TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093301",
"telephone_number": "510-465-8012",
"fax_number": "510-835-1626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIGIACOMO",
"first_name": "MICHAEL",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2015-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CA",
"license": "E1909",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL PROVIDER NUMBER",
"identifier": "000E19090",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.