Gennady Kolodenker, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E4880 Issued in CA

Practice address

16405 Sand Canyon Ave
Suite 270
Irvine, CA 92618-3785

Phone

(949) 651-1202

Fax

(949) 552-9493

NPI assigned

Dec 11, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foot and Ankle SpecialistGroup PAC ID 4587847389, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Foot and Ankle Specialist

  • Foot & Ankle Surgery Podiatrist
  • Irvine, CA
  • NPI 1053616086
  Medicare reassignment Care Compare group Authorized official
• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  NPD (past)
• Saddleback Memorial Medical Center

  • Rehabilitation Hospital Unit
  • Laguna Hills, CA
  • NPI 1114967114
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  Care Compare affiliation

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

{
    "created_epoch": "1228953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1659516151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16405 SAND CANYON AVE",
            "address_2": "SUITE 270",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183785",
            "telephone_number": "949-651-1202",
            "fax_number": "949-552-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16405 SAND CANYON AVE",
            "address_2": "SUITE 270",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183785",
            "telephone_number": "949-651-1202",
            "fax_number": "949-552-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLODENKER",
        "first_name": "GENNADY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-11",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4880",
            "primary": true
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "CA",
            "license": "E4880",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dongwuk Koh
• Maryam Kohanbani, RNFA,CNOR
• Diane Elizabeth Kohler, RDN
• Casey Kohn, LMFT
• Sudarsan Kollimuttathuillam, MD
• Erum Kolsy
• Komi Optical, Inc.
• Komi Optical, Inc.
• Chloe Emerson Komrosky
• Erin Konchan, FNP

• Foot & Ankle Surgery Podiatrist in Irvine, CA
• Providers in Irvine, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; 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.