Individual provider Active NPI

Mariam Botros, DPM

  • Foot & Ankle Surgery Podiatrist
  • Arcadia, CA
National Provider Identifier
1619328457
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
EL6794 Issued in CA
Practice address
450 E Huntington Dr
Arcadia, CA 91006-3748
Phone
(626) 462-1884
NPI assigned
Jun 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X EL6794 CA Primary

Addresses

Primary practice location

450 E Huntington Dr
Arcadia, CA 91006-3748

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other practice location 1

2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (562) 933-7243 ext. 18881

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
I20190730000569 CA Practitioner - Podiatry 6608102611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Western University of Health Sciences College of Dental Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1236 N Magnolia Ave
Anaheim, CA 92801-2607
Phone (714) 995-1000

225 W Broadway
Suite 100
Glendale, CA 91204-1393
Phone (818) 545-7117

450 E Huntington Dr
Arcadia, CA 91006-3748
Phone (626) 254-2100

824 E Carson St
Suite 104
Carson, CA 90745-2262
Phone (310) 830-9706

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue44
Removal or shaving of skin growth14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
EL6794CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Oct 10, 2022 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Oct 10, 2022 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

450 E Huntington Dr
Arcadia, CA 91006
Phone (626) 254-2100

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

14600 Sherman Way
Ste 300
Van Nuys, CA 91405
Phone (818) 208-7138

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mbotros206979@westdirect.optum.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1619328457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E HUNTINGTON DR",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063748",
            "telephone_number": "626-462-1884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908061701",
            "country_code": "US",
            "telephone_number": "562-933-7243 x18881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTROS",
        "first_name": "MARIAM",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "EL6794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.