Individual provider Active NPI

Roland A Gaskins, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Moreno Valley, CA
National Provider Identifier
1710910872
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E3646 Issued in CA
Practice address
23025 Atlantic Cir
Suite C
Moreno Valley, CA 92553-5909
Phone
(951) 486-8618
Fax
(951) 486-9018
NPI assigned
Jul 9, 2006
Last updated
Mar 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E3646 CA Primary

Addresses

Primary practice location

23025 Atlantic Cir
Suite C
Moreno Valley, CA 92553-5909

Mailing address

PO Box 7903
Moreno Valley, CA 92552-7903
Phone (951) 486-8618

Other identifiers 1

IdentifierTypeStateIssuer
0732624MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120224000543 CA Practitioner - Podiatry 2961610894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23025 Atlantic Cir
Suite C
Moreno Valley, CA 92553-5909
Phone (951) 486-8618

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue15
Removal of skin lesions1-10
Removal of nail tissue635
Removal or shaving of skin growth14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E3646CAMDFoot & Ankle Surgery Podiatrist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1710910872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7903",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925527903",
            "telephone_number": "951-486-8618",
            "fax_number": "951-486-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23025 ATLANTIC CIR",
            "address_2": "SUITE C",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925535909",
            "telephone_number": "951-486-8618",
            "fax_number": "951-486-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASKINS",
        "first_name": "ROLAND",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0732624",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.