Active NPI
Steven Daniel Dickerson
- Foot & Ankle Surgery Podiatrist
- San Marcos, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- E5874
- Practice address
- 1595 Grand Ave Ste 106
San Marcos, CA 92078-2450 - Phone
- (760) 736-6767
- NPI assigned
- Jun 10, 2019
- Sex
- Male
- Sole proprietor
- No
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 | E5874 | CA | Primary |
Addresses
Primary practice location
1595 Grand Ave Ste 106
San Marcos, CA 92078-2450
Mailing address
150 Valpreda Rd
San Marcos, CA 92069-2973
Phone (760) 736-6767
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1595 Grand Ave
Suite 106
San Marcos, CA 92078-2450
Phone (760) 736-6767
Merit-based Incentive Payment System (MIPS)
- Final score
- 17.5 of 100
- Quality
- 15
- Improvement activities
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 22 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 2023 |
| Removal or shaving of skin growth | 697 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E5874 | CA | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North County Health Project Inc | Current | Accepting new patients | |
| North County Health Project Inc | Current | Accepting new patients | |
| North County Health Project Inc | Current | Accepting new patients | |
| Toe-Tal Family Footcare | Past | Accepting new patients |
Locations
150 Valpreda Rd
San Marcos, CA 92069
Phone (619) 736-6700
1595 Grand Ave
Ste 100
San Marcos, CA 92078
Phone (760) 444-0523
1595 Grand Ave
Ste 106
San Marcos, CA 92078
Phone (760) 471-2440
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- sdickerson844717@direct.ochin.org
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.
-
- Federally Qualified Health Center (FQHC)
- San Marcos, CA
- NPI 1245246917
-
- Federally Qualified Health Center (FQHC)
- San Marcos, CA
- NPI 1588489975
-
- Federally Qualified Health Center (FQHC)
- Oceanside, CA
- NPI 1982475729
-
- Primary Podiatric Medicine Podiatrist
- Las Vegas, NV
- NPI 1821749615
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764633600000",
"number": "1851950257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 VALPREDA RD",
"city": "SAN MARCOS",
"state": "CA",
"postal_code": "920692973",
"telephone_number": "760-736-6767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1595 GRAND AVE STE 106",
"city": "SAN MARCOS",
"state": "CA",
"postal_code": "920782450",
"telephone_number": "760-736-6767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "STEVEN",
"middle_name": "DANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-10",
"last_updated": "2025-12-02",
"certification_date": "2025-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CA",
"license": "E5874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Marcos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.