Organization Active NPI

Socal Foot Care PC

Doing business as Socal Foot Care

  • Foot & Ankle Surgery Podiatrist
  • Escondido, CA
National Provider Identifier
1922842541
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
SOCAL FOOT CARE PC
Doing business as
Socal Foot Care
Practice address
1147 E Grand Ave
Escondido, CA 92025-3219
Phone
(760) 738-1583
Fax
(858) 450-3296
NPI assigned
Jun 19, 2024
Organization subpart
Yes
Parent organization
SOCAL FOOT CARE PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Authorized official

Name
Alexander Reyzelman, DPM
Title
Rcmo
Phone
(415) 292-0638

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1147 E Grand Ave
Escondido, CA 92025-3219

Mailing address

PO Box 34869
Belfast, ME 04915-0626
Phone (858) 450-9218

Other names 1

  • SOCAL FOOT CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240719001245 CA DME Supplier - Physician - Podiatry 5395110076 Practice locations: Escondido, CA

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Socal Foot Care PC10 organizations share this tax ID, including this one
Part of
Socal Foot Care PC

Other organizations with this tax ID 9

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1147 E Grand Ave
Escondido, CA 92025
Phone (760) 738-1583

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1922842541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34869",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049150626",
            "telephone_number": "858-450-9218",
            "fax_number": "858-450-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 E GRAND AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253219",
            "telephone_number": "760-738-1583",
            "fax_number": "858-450-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL FOOT CARE PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOCAL FOOT CARE PC",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "REYZELMAN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "RCMO",
        "authorized_official_telephone_number": "415-292-0638",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOCAL FOOT CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.