Active NPI
Romeo Joseph Pettinelli, DPM
- Foot & Ankle Surgery Podiatrist
- Studio City, CA
National Provider Identifier
1740369792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- E2873
- Practice address
- 12660 Riverside Dr Ste 305
Studio City, CA 91607-3431 - Phone
- (818) 623-4455
- Fax
- (818) 985-0055
- NPI assigned
- Nov 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | E2873 | CA | Primary |
Addresses
Primary practice location
12660 Riverside Dr Ste 305
Studio City, CA 91607-3431
Mailing address
12660 Riverside Dr Ste 305
Studio City, CA 91607-3431
Phone (818) 623-4455
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
| License | State | Type | Specialty |
|---|---|---|---|
| E2873 | CA | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Studio City Surgical Center | Past | Accepting new patients | |
| Foot and Ankle Institute of the West | Foot & Ankle Surgery | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Foot & Ankle Surgery Podiatrist
- Agoura Hills, CA
- NPI 1487723219
-
- Ambulatory Surgical Clinic/Center
- Studio City, CA
- NPI 1437360849
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740369792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12660 RIVERSIDE DR STE 305",
"city": "STUDIO CITY",
"state": "CA",
"postal_code": "916073431",
"telephone_number": "818-623-4455",
"fax_number": "818-985-0055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12660 RIVERSIDE DR STE 305",
"city": "STUDIO CITY",
"state": "CA",
"postal_code": "916073431",
"telephone_number": "818-623-4455",
"fax_number": "818-985-0055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTINELLI",
"first_name": "ROMEO",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CA",
"license": "E2873",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Studio City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.