NPIMap

Organization Active NPI

Orange County Foot and Ankle Group, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Fullerton, CA
National Provider Identifier
1639102833
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4301 Issued in CA
Legal business name
ORANGE COUNTY FOOT AND ANKLE GROUP, INC.
Practice address
300 N Euclid St
Suite a
Fullerton, CA 92832-1623
Phone
(714) 888-6860
Fax
(714) 888-6867
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

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

Authorized official

Name
Dr. Jonathan Ian Bennett, D.P.M.NPI 1497850325
Title
President
Phone
(714) 888-6860

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X E4301 CA Primary

Addresses

Primary practice location

300 N Euclid St
Suite a
Fullerton, CA 92832-1623

Mailing address

300 N Euclid St
Suite a
Fullerton, CA 92832-1623
Phone (714) 888-6860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040831000544 CA Part B Supplier - Clinic/Group Practice 1658346978 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
Practice locations: Tustin, CA; Santa Ana, CA; Fullerton, CA
O20100930008403 CA DME Supplier - Physician - Podiatry 1658346978 Practice locations: Fullerton, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1801 W Romneya Dr
Ste 308
Anaheim, CA 92801
Phone (714) 996-1633

300 N Euclid St
#A
Fullerton, CA 92832
Phone (714) 888-6860

16511 Goldenwest St
Ste 109
Huntington Beach, CA 92647
Phone (714) 847-9000

500 W 17th St
Ste A
Santa Ana, CA 92706
Phone (714) 558-7727

2492 Walnut Ave
Tustin, CA 92780
Phone (714) 544-2188

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521417600000",
    "number": "1639102833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N EUCLID ST",
            "address_2": "SUITE A",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321623",
            "telephone_number": "714-888-6860",
            "fax_number": "714-888-6867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N EUCLID ST",
            "address_2": "SUITE A",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321623",
            "telephone_number": "714-888-6860",
            "fax_number": "714-888-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE COUNTY FOOT AND ANKLE GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2018-03-19",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-888-6860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.