NPIMap

Organization Active NPI

Wellness Podiatry Corp

Doing business as Auburn Podiatry

  • Podiatrist
  • Auburn, CA
National Provider Identifier
1912696782
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
WELLNESS PODIATRY CORP
Doing business as
Auburn Podiatry
Practice address
3257 Professional Dr Ste E
Auburn, CA 95602-2460
Phone
(503) 823-7171
NPI assigned
May 5, 2023
Last updated
Aug 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Authorized official

Name
Benjamin Pham, DPMNPI 1194884387
Title
Owner
Phone
(510) 551-3804

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary
Foot & Ankle Surgery Podiatrist 213ES0103X NU

Addresses

Primary practice location

3257 Professional Dr Ste E
Auburn, CA 95602-2460

Mailing address

685 Twelve Bridges Dr Ste F
Lincoln, CA 95648-8689
Phone (916) 786-3434

Other practice location 1

5025 J St Ste 316
Sacramento, CA 95819-3839
Phone (916) 732-2277

Other names 1

  • AUBURN PODIATRY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230726004024 CA Part B Supplier - Clinic/Group Practice 4688035439 Receives reassigned benefits from 3 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Auburn, CA; Lincoln, CA; Roseville, CA; Sacramento, CA
O20240216001269 CA DME Supplier - Physician - Podiatry 4688035439 Practice locations: Auburn, CA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Wellness Podiatry Corp5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3257 Professional Dr
Ste E
Auburn, CA 95602
Phone (530) 823-0701

1650 Lead Hill Blvd
Ste 100
Roseville, CA 95661
Phone (916) 669-5805

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1683244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1912696782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 TWELVE BRIDGES DR STE F",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956488689",
            "telephone_number": "916-786-3434",
            "fax_number": "916-786-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3257 PROFESSIONAL DR STE E",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956022460",
            "telephone_number": "503-823-7171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5025 J St Ste 316",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958193839",
            "country_code": "US",
            "telephone_number": "916-732-2277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLNESS PODIATRY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-05",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-551-3804",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AUBURN PODIATRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Auburn, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.