Individual provider Active NPI

Francisco Guadalupe Mendivil Moreno, DPM

  • Foot & Ankle Surgery Podiatrist
  • Ontario, CA
National Provider Identifier
1871989475
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E5452 Issued in CA
Practice address
728 N Euclid Ave
Ontario, CA 91762-2712
Phone
(909) 984-5614
NPI assigned
Apr 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X E5452 CA
Foot & Ankle Surgery Podiatrist 213ES0103X E5452 CA Primary

Addresses

Primary practice location

728 N Euclid Ave
Ontario, CA 91762-2712

Mailing address

1226 W Taylor St
Chicago, IL 60607-4709
Phone (909) 499-2625

Other practice location 1

16465 Sierra Lakes Pwky #240
Fontana, CA 92336
Phone (909) 427-9522

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
I20181107002069 CA Practitioner - Podiatry 9739433905 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

728 N Euclid Ave
Ontario, CA 91762-2712
Phone (909) 984-5614

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue47
Removal of skin lesions1-10
Removal of nail tissue452
Removal or shaving of skin growth99

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5452CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Burbank Podiatry Asscociates Group a Professional Corporation Foot & Ankle Surgery CurrentSince Jan 15, 2025 Accepting new patients
Family Foot Center Podiatry Group Inc. CurrentSince Aug 9, 2018 Accepting new patients
Upperline Healthcare California PC Foot & Ankle Surgery CurrentSince Nov 1, 2021 Accepting new patients
Upperline Healthcare California, PC Orthopaedic Surgery CurrentSince Nov 1, 2021 Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Primecare Medical Group Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients

Locations

15315 Fairfield Ranch Rd
Ste 220
Chino Hills, CA 91709
Phone (909) 789-1130

308 W 6th St
Ste 205
Corona, CA 92882
Phone (951) 417-4556

16465 Sierra Lakes Pkwy
Ste 240
Fontana, CA 92336
Phone (909) 355-3100

728 N Euclid Ave
Ontario, CA 91762
Phone (909) 984-4759

3600 Central Ave
Ste 4
Riverside, CA 92506
Phone (951) 355-2956

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: francisco.mendivil.moreno.1@4399.direct.athenahealth.com

Organizations & group practices 7

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": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1871989475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074709",
            "telephone_number": "909-499-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917622712",
            "telephone_number": "909-984-5614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16465 Sierra Lakes Pwky #240",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "92336",
            "country_code": "US",
            "telephone_number": "909-427-9522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDIVIL MORENO",
        "first_name": "FRANCISCO",
        "middle_name": "GUADALUPE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-09",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "CA",
            "license": "E5452",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.