Active NPI
Peter Charles Squellati, D.P.M.
- Foot & Ankle Surgery Podiatrist
- Burlingame, CA
National Provider Identifier
1629154026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- E2272
- Practice address
- 1750 El Camino Real
Suite 105
Burlingame, CA 94010-3228 - Phone
- (650) 342-2420
- Fax
- (650) 342-2391
- NPI assigned
- Oct 27, 2006
- Sex
- Male
- Sole proprietor
- No
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 | E2272 | CA | Primary |
Addresses
Primary practice location
1750 El Camino Real
Suite 105
Burlingame, CA 94010-3228
Mailing address
1750 El Camino Real
Suite 105
Burlingame, CA 94010-3228
Phone (650) 342-2420
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 |
|---|---|---|---|
| E2272 | CA | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427760000000",
"number": "1629154026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1750 EL CAMINO REAL",
"address_2": "SUITE 105",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "940103228",
"telephone_number": "650-342-2420",
"fax_number": "650-342-2391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 EL CAMINO REAL",
"address_2": "SUITE 105",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "940103228",
"telephone_number": "650-342-2420",
"fax_number": "650-342-2391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SQUELLATI",
"first_name": "PETER",
"middle_name": "CHARLES",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2015-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CA",
"license": "E2272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlingame, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.