Individual provider Active NPI

James Leonard Knudson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Culver City, CA
National Provider Identifier
1851356109
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E2159 Issued in CA
Practice address
9808 Venice Blvd Ste 600
Culver City, CA 90232-6807
Phone
(310) 876-1579
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E2159 CA
Foot & Ankle Surgery Podiatrist 213ES0103X E2159 CA Primary

Addresses

Primary practice location

9808 Venice Blvd Ste 600
Culver City, CA 90232-6807

Mailing address

PO Box 368
Culver City, CA 90232-0368
Phone (310) 994-9376

Other identifiers 1

IdentifierTypeStateIssuer
000E21590MedicaidCA

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
I20101109000398 CA Practitioner - Podiatry 8123231552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9808 Venice Blvd
Suite 600
Culver City, CA 90232-6807
Phone (310) 876-1579

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue118
Removal of nail tissue1157
Removal or shaving of skin growth663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2159CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Foot Care Clinic, Inc Podiatrist CurrentSince Aug 23, 1982 Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients

Locations

9808 Venice Blvd
Ste 600
Culver City, CA 90232
Phone (310) 204-2300

9640 Venice Blvd
Culver City, CA 90232
Phone (310) 803-6013

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1851356109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902320368",
            "telephone_number": "310-994-9376",
            "fax_number": "310-202-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD STE 600",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326807",
            "telephone_number": "310-876-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSON",
        "first_name": "JAMES",
        "middle_name": "LEONARD",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E2159",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E2159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E21590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.