Organization Active NPI

Socal Podiatry, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Downey, CA
National Provider Identifier
1689067266
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E5157 Issued in CA
Legal business name
SOCAL PODIATRY, P.C.
Practice address
11411 Brookshire Ave Ste 501
Downey, CA 90241-5007
Phone
(562) 651-1050
Fax
(562) 868-2828
NPI assigned
Mar 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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

Authorized official

Name
Dr. Stephen Allen Boykins, DPMNPI 1689014318
Title
President/Ceo
Phone
(954) 734-0713

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 E5157 CA Primary

Addresses

Primary practice location

11411 Brookshire Ave Ste 501
Downey, CA 90241-5007

Mailing address

PO Box 1321
Moreno Valley, CA 92556-1321
Phone (954) 734-0713

Other practice location 1

22635 Alessandro Blvd Ste E
Moreno Valley, CA 92553-8550
Phone (951) 653-0200

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150406000920 CA Part B Supplier - Clinic/Group Practice 4587982418 Receives reassigned benefits from 1 practitioner
Practice locations: Downey, CA; Moreno Valley, CA
O20200411000223 CA DME Supplier - Physician - Podiatry 4587982418 Practice locations: Downey, CA

National Provider Directory

National Provider Directory

Locations

285 W Chanslor Way
Blythe, CA 92225
Phone (760) 922-8176

11411 Brookshire Ave
Ste 501
Downey, CA 90241
Phone (562) 651-1050

22635 Alessandro Blvd
Moreno Valley, CA 92553
Phone (951) 242-2226

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538352000000",
    "number": "1689067266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1321",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925561321",
            "telephone_number": "954-734-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11411 BROOKSHIRE AVE STE 501",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902415007",
            "telephone_number": "562-651-1050",
            "fax_number": "562-868-2828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22635 Alessandro Blvd Ste E",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925538550",
            "country_code": "US",
            "telephone_number": "951-653-0200",
            "fax_number": "951-653-0201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOCAL PODIATRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-06",
        "last_updated": "2018-10-01",
        "status": "A",
        "authorized_official_last_name": "BOYKINS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "954-734-0713",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.