Progressive Foot and Ankle Institute PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E5019 Issued in CA

Legal business name

PROGRESSIVE FOOT AND ANKLE INSTITUTE PC

Practice address

3030 W Temple St
Ste 106
Los Angeles, CA 90026-4533

Phone

(213) 387-9251

Fax

(213) 387-9241

NPI assigned

Sep 13, 2013

Organization subpart

No

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

Authorized official

Name

Aleksander Valentinovich Lavrenov, D.P.MNPI 1992937379

Title

President

Phone

(917) 687-7528

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Aleksander Valentinovich Lavrenov, DPM

  • Foot & Ankle Surgery Podiatrist
  • Woodland Hills, CA
  • NPI 1992937379
  Medicare reassignment NPD Authorized official
• Alla Lavrenova, NP

  • Nurse Practitioner
  • New York, NY
  • NPI 1881794105
  NPD

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379030400000",
    "number": "1689009227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20548 VENTURA BLVD",
            "address_2": "APT 217",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913646225",
            "telephone_number": "917-687-7528",
            "fax_number": "213-387-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 W TEMPLE ST",
            "address_2": "STE 106",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264533",
            "telephone_number": "213-387-9251",
            "fax_number": "213-387-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE FOOT AND ANKLE INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A",
        "authorized_official_last_name": "LAVRENOV",
        "authorized_official_first_name": "ALEKSANDER",
        "authorized_official_middle_name": "VALENTINOVICH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-687-7528",
        "authorized_official_credential": "D.P.M"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Los Angeles, CA
• Providers in Los Angeles, 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 Sep 13, 2013; 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.