Individual provider Active NPI

Steven Daniel Dickerson

  • Foot & Ankle Surgery Podiatrist
  • San Marcos, CA
National Provider Identifier
1851950257
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E5874 Issued in CA
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

Updated by the provider on Dec 2, 2025

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220621001263 CA Practitioner - Podiatry 8022497130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North County Health Project IncGroup PAC ID 2769390939, 56 clinicians

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 100Reported as individual
Quality
15
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue22
Removal of skin lesions1-10
Removal of nail tissue2023
Removal or shaving of skin growth697

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5874CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
North County Health Project Inc CurrentSince Dec 1, 2025 Accepting new patients
North County Health Project Inc CurrentSince Dec 1, 2025 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.