Individual provider Active NPI

Dale Roger Mascari, D.P,M.

  • Podiatrist
  • Los Angeles, CA
National Provider Identifier
1679787873
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E1915 Issued in CA
Practice address
5636 N Figueroa St
Los Angeles, CA 90042-4102
Phone
(323) 255-1441
Fax
(323) 255-7277
NPI assigned
May 9, 2007
Last updated
Dec 17, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E1915 CA Primary

Addresses

Primary practice location

5636 N Figueroa St
Los Angeles, CA 90042-4102

Mailing address

5636 N Figueroa St
Los Angeles, CA 90042-4102
Phone (323) 255-1441

Other identifiers 1

IdentifierTypeStateIssuer
000E19151MedicaidCA

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

LicenseStateTypeSpecialty
E1915CAMDPodiatrist

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1679787873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5636 N FIGUEROA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900424102",
            "telephone_number": "323-255-1441",
            "fax_number": "323-255-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5636 N FIGUEROA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900424102",
            "telephone_number": "323-255-1441",
            "fax_number": "323-255-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCARI",
        "first_name": "DALE",
        "middle_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "D.P,M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E1915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E19151",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.