Individual provider Active NPI

Maria Theresa Panlilio Sanicolas, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • National City, CA
National Provider Identifier
1891893962
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4303 Issued in CA
Practice address
610 Euclid Ave
Ste. 304
National City, CA 91950-2953
Phone
(619) 470-6800
Fax
(866) 232-7229
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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 E4303 CA Primary

Addresses

Primary practice location

610 Euclid Ave
Ste. 304
National City, CA 91950-2953

Mailing address

610 Euclid Ave
Ste. 304
National City, CA 91950-2953
Phone (619) 470-6800

Other identifiers 1

IdentifierTypeStateIssuer
000E43030MedicaidCA

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
I20101015000868 CA Practitioner - Podiatry 5597765172

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4303CAMDFoot & Ankle Surgery Podiatrist
4303CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Home Foot Care, LLP Past Accepting new patients
Lepow Podiatric Medical Associates Foot & Ankle Surgery Past Accepting new patients
Lepow Podiatric Medical Associates Past Accepting new patients

Organizations & group practices 3

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282608000000",
    "number": "1891893962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 EUCLID AVE",
            "address_2": "STE. 304",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502953",
            "telephone_number": "619-470-6800",
            "fax_number": "866-232-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 EUCLID AVE",
            "address_2": "STE. 304",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502953",
            "telephone_number": "619-470-6800",
            "fax_number": "866-232-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANICOLAS",
        "first_name": "MARIA THERESA",
        "middle_name": "PANLILIO",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E43030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.