Individual provider Active NPI

Tiffany Chin, DPM

  • Foot & Ankle Surgery Podiatrist
  • Los Angeles, CA
National Provider Identifier
1811459175
Registry record updated Apr 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E5792 Issued in CA
Practice address
1414 S Grand Ave Ste 210
Los Angeles, CA 90015-3067
Phone
(213) 455-8448
NPI assigned
Apr 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2024

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 E5792 CA Primary

Addresses

Primary practice location

1414 S Grand Ave Ste 210
Los Angeles, CA 90015-3067

Mailing address

8700 Beverly Blvd Ste 8215NT
West Hollywood, CA 90048-1804

Other practice location 1

8700 Beverly Blvd Ste 8215Nt
West Hollywood, CA 90048-1804
Phone (310) 423-6637

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
I20220603002062 CA Practitioner - Podiatry 7810375854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brian D Solberg MD IncGroup PAC ID 3577614148, 4 clinicians

Practice addresses (Care Compare)

1414 S Grand Ave
Suite 123
Los Angeles, CA 90015-3071
Phone (213) 455-8448

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5792CAMDFoot & 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714176000000",
    "number": "1811459175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD STE 8215NT",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 S GRAND AVE STE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153067",
            "telephone_number": "213-455-8448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 Beverly Blvd Ste 8215Nt",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900481804",
            "country_code": "US",
            "telephone_number": "310-423-6637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIN",
        "first_name": "TIFFANY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2024-04-27",
        "certification_date": "2024-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.