Individual provider Active NPI

Mario G Porciello-Donnarumma, DPM

  • Foot & Ankle Surgery Podiatrist
  • Santa Monica, CA
National Provider Identifier
1790309672
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E5925 Issued in CA
Practice address
2121 Wilshire Blvd Ste 101
Santa Monica, CA 90403-5742
Phone
(310) 828-0011
Fax
(310) 828-2001
NPI assigned
Jun 5, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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 E5925 CA Primary

Addresses

Primary practice location

2121 Wilshire Blvd Ste 101
Santa Monica, CA 90403-5742

Mailing address

PO Box 841868
Los Angeles, CA 90084-1868

Other practice location 1

333 Corporate Dr Ste 230
Ladera Ranch, CA 92694-2180
Phone (949) 364-9255

Other practice location 2

2617 E Chapman Ave Ste 303
Orange, CA 92869-3256
Phone (714) 639-7993

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
I20230530000047 CA Practitioner - Podiatry 7618334160 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Home Foot Care IncGroup PAC ID 4981744257, 25 clinicians
Spencer Rodriguez Podiatry CorporationGroup PAC ID 9739305061, 3 clinicians

Practice addresses (Care Compare)

12520 Magnolia Blvd
Suite 304
Valley Village, CA 91607-2355
Phone (818) 452-9902

2121 Wilshire Blvd
Suite 101
Santa Monica, CA 90403-5742
Phone (310) 828-0011

333 Corporate Dr
Suite 230
Ladera Ranch, CA 92694-2180
Phone (949) 364-9255

Hospital & facility affiliations

  • Chapman Global Medical Center Hospital, Orange, CA, CCN 050745

Merit-based Incentive Payment System (MIPS)

Final score
72.4 of 100Reported as group
Quality
44.81
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue17
Removal of nail tissue1041
Removal or shaving of skin growth534
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5925CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Rodriguez Podiatry Corporation Foot & Ankle Surgery CurrentSince Jul 1, 2023 Accepting new patients
Spencer Rodriguez Podiatry Corporation Foot & Ankle Surgery CurrentSince Jul 1, 2023 Accepting new patients
University Foot and Ankle Institute a Podiatric Surgical Center Foot & Ankle Surgery Past Accepting new patients

Locations

333 Corporate Dr
Ste 230
Ladera Ranch, CA 92694
Phone (949) 364-9255

2617 E Chapman Ave
Ste 303
Orange, CA 92869
Phone (714) 639-7993

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1790309672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841868",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900841868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 WILSHIRE BLVD STE 101",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035742",
            "telephone_number": "310-828-0011",
            "fax_number": "310-828-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Corporate Dr Ste 230",
            "address_purpose": "LOCATION",
            "city": "Ladera Ranch",
            "state": "CA",
            "postal_code": "926942180",
            "country_code": "US",
            "telephone_number": "949-364-9255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2617 E Chapman Ave Ste 303",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928693256",
            "country_code": "US",
            "telephone_number": "714-639-7993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORCIELLO-DONNARUMMA",
        "first_name": "MARIO",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-05",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.