Individual provider Active NPI

Richard Gordon Picha, DPM

  • Podiatrist
  • Saint Paul, MN
National Provider Identifier
1811009970
Registry record updated Feb 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
288 Issued in MN
Practice address
1919 University Ave W
Ste TLC
Saint Paul, MN 55104-3453
Phone
(952) 926-6670
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 288 MN Primary

Addresses

Primary practice location

1919 University Ave W
Ste TLC
Saint Paul, MN 55104-3453

Mailing address

6015 Park Ave
Minneapolis, MN 55417-3123
Phone (952) 926-6670

Other identifiers 5

IdentifierTypeStateIssuer
2728653OtherMEDICA
100466OtherCL CARE
3600355MedicaidMN
582525300MedicaidMN
480610048OtherRR MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20080930000018 MN Practitioner - Podiatry 5092882290 Practice locations: Saint Paul, MN

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Phase Two Podiatry PC Podiatrist CurrentSince Sep 16, 2019 Accepting new patients

Locations

3245 Vera Cruz Ave N
Robbinsdale, MN 55422
Phone (516) 729-0070

301 Mill Rd
Ste U7
Hewlett, NY 11557

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392163200000",
    "number": "1811009970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554173123",
            "telephone_number": "952-926-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 UNIVERSITY AVE W",
            "address_2": "STE TLC",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043453",
            "telephone_number": "952-926-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICHA",
        "first_name": "RICHARD",
        "middle_name": "GORDON",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2728653",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CL CARE",
            "identifier": "100466",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3600355",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "582525300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "480610048",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.