Grigoriy N Patish, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

E4987 Issued in CA

Practice address

407 Potter St Ste a
Fallbrook, CA 92028-3086

Phone

(760) 728-4800

Fax

(760) 728-0061

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fallbrook Podiatry, Inc

  • Primary Podiatric Medicine Podiatrist
  • Fallbrook, CA
  • NPI 1861825523

  Single Specialty

  Medicare reassignment NPD Authorized official
• Grace Ting, DPM, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Alhambra, CA
  • NPI 1245266576
  Medicare reassignment
• Patish DPM PC

  • Podiatrist
  • Rego Park, NY
  • NPI 1811264344

  Single Specialty

  NPD (past) Authorized official
• Frank J Witt DPM

  • Podiatric Clinic/Center
  • Fallbrook, CA
  • NPI 1912360140
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1609817535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 POTTER ST STE A",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283086",
            "telephone_number": "760-728-4800",
            "fax_number": "760-728-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 POTTER ST STE A",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283086",
            "telephone_number": "760-728-4800",
            "fax_number": "760-728-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATISH",
        "first_name": "GRIGORIY",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005980",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00298800",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CA",
            "license": "E4987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02639412",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Partners
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• Primary Podiatric Medicine Podiatrist in Fallbrook, CA
• Providers in Fallbrook, CA by specialty
• Primary Podiatric Medicine Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.