Organization Active NPI

Bay Area Foot Care, Inc

  • Foot & Ankle Surgery Podiatrist
  • Modesto, CA
National Provider Identifier
1740045954
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
BAY AREA FOOT CARE, INC
Practice address
730 16TH St
Modesto, CA 95354-2519
Phone
(209) 550-5893
Fax
(209) 550-0171
NPI assigned
Feb 16, 2024
Organization subpart
Yes
Parent organization
BAY AREA FOOT CARE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Authorized official

Name
Alexander Reyzelman, DPM
Title
Chief Regional Medical Officer
Phone
(415) 292-0638

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

730 16TH St
Modesto, CA 95354-2519

Mailing address

20130 Lake Chabot Rd Ste 202
Castro Valley, CA 94546-5340
Phone (510) 581-1484

Other names 1

  • Bay Area Foot Care Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241009002475 CA DME Supplier - Physician - Podiatry 0345329686 Practice locations: Modesto, CA

National Provider Directory

National Provider Directory
Tax ID family
Bay Area Foot Care Inc47 organizations share this tax ID, including this one
Part of
Bay Area Foot Care Inc

Other organizations with this tax ID 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1740045954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20130 LAKE CHABOT RD STE 202",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465340",
            "telephone_number": "510-581-1484",
            "fax_number": "510-581-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 16TH ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953542519",
            "telephone_number": "209-550-5893",
            "fax_number": "209-550-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA FOOT CARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAY AREA FOOT CARE, INC",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "REYZELMAN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "CHIEF REGIONAL MEDICAL OFFICER",
        "authorized_official_telephone_number": "415-292-0638",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Area Foot Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bay Area Foot Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.