Individual provider Active NPI

Johnny Chong Huang, D.P.M.

  • Podiatrist
  • Montebello, CA
National Provider Identifier
1568825958
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E5501 Issued in CA
Practice address
1417 W Beverly Blvd Ste 104
Montebello, CA 90640-4125
Phone
(323) 721-6026
NPI assigned
Apr 1, 2016
Last updated
Oct 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E5501 CA Primary

Addresses

Primary practice location

1417 W Beverly Blvd Ste 104
Montebello, CA 90640-4125

Mailing address

1417 W Beverly Blvd Ste 104
Montebello, CA 90640-4125
Phone (323) 721-6026

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
I20200130001350 CA Practitioner - Podiatry 1759620685 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1417 W Beverly Blvd
Suite 104
Montebello, CA 90640-4125
Phone (323) 721-6026

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue35
Removal of skin lesions26
Removal of nail tissue513
Removal or shaving of skin growth192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5501CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Foot Center Podiatry Group Inc. Podiatrist CurrentSince Sep 28, 2019 Accepting new patients
West Beverly Podiatry Group, Inc. Podiatrist CurrentSince Mar 12, 2024 Accepting new patients
Primecare Medical Group Past Accepting new patients
West Beverly Podiatry Group, Inc Podiatrist Past Accepting new patients

Locations

15315 Fairfield Ranch Rd
Ste 220
Chino Hills, CA 91709
Phone (909) 789-1130

931 Buena Vista St
Ste 305
Duarte, CA 91010
Phone (626) 447-5122

16465 Sierra Lakes Pkwy
Ste 240
Fontana, CA 92336
Phone (909) 355-3100

16465 Sierra Lakes Pkwy
Ste 245
Fontana, CA 92336
Phone (909) 350-3003

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

1601 W Beverly Blvd
Montebello, CA 90640
Phone (323) 721-6026

728 N Euclid Ave
Ontario, CA 91762
Phone (909) 984-5614

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1568825958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 W BEVERLY BLVD STE 104",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404125",
            "telephone_number": "323-721-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 W BEVERLY BLVD STE 104",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404125",
            "telephone_number": "323-721-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "JOHNNY",
        "middle_name": "CHONG",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-01",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

Verify at the official NPI Registry.