Individual provider Active NPI

Daphne Shienmei Yen-Douangmala, DPM

  • Foot & Ankle Surgery Podiatrist
  • Vallejo, CA
National Provider Identifier
1902117575
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
EL1833 Issued in CA
Practice address
975 Sereno Dr
Vallejo, CA 94589-2441
Phone
(847) 687-1411
Fax
(707) 651-3685
NPI assigned
Jun 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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 EL1833 CA Primary

Addresses

Primary practice location

975 Sereno Dr
Vallejo, CA 94589-2441

Mailing address

213 Antoinette CT
Novato, CA 94947-5131
Phone (847) 687-1411

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
I20150616002732 CA Practitioner - Podiatry 2466763503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 N Euclid St
Suite a
Fullerton, CA 92832-1623
Phone (714) 888-6860

300 N Euclid St a
Fullerton, CA 92832-1623

Merit-based Incentive Payment System (MIPS)

Final score
90 of 100Reported as group
Quality
62.38
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue90
Removal of skin lesions1-10
Removal of nail tissue742
Removal or shaving of skin growth595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
EL1833CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Foot & Ankle Group, Inc. Foot & Ankle Surgery Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dyen@ocfa.mdlogic.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1902117575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 ANTOINETTE CT",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949475131",
            "telephone_number": "847-687-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SERENO DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892441",
            "telephone_number": "847-687-1411",
            "fax_number": "707-651-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEN-DOUANGMALA",
        "first_name": "DAPHNE",
        "middle_name": "SHIENMEI",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "EL1833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.