NPIMap

Organization Active NPI

Agoura-Los Robles Podiatry Centers

  • Foot & Ankle Surgery Podiatrist
  • Thousand Oaks, CA
National Provider Identifier
1932386877
Registry record updated May 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
AGOURA-LOS ROBLES PODIATRY CENTERS
Practice address
555 Marin St
Suite 290
Thousand Oaks, CA 91360-4236
Phone
(818) 707-3668
NPI assigned
Jan 22, 2008
Last updated
May 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2020

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

Authorized official

Name
Darren Payne, DPMNPI 1922195452
Title
Partner
Phone
(818) 707-3668

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 1

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

Addresses

Primary practice location

555 Marin St
Suite 290
Thousand Oaks, CA 91360-4236

Mailing address

555 Marin St
Suite 290
Thousand Oaks, CA 91360-4236
Phone (818) 707-3668

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080731000331 CA Part B Supplier - Clinic/Group Practice 0648344200 Receives reassigned benefits from 7 practitioners
Practice locations: Agoura Hills, CA; Simi Valley, CA; Thousand Oaks, CA
O20130814000413 CA DME Supplier - Physician - Unknown Physician Specialty 0648344200 Practice locations: Thousand Oaks, CA

National Provider Directory

National Provider Directory

Locations

5115 Clareton Dr
Agoura Hills, CA 91301

5115 Clareton Dr
Ste 120
Agoura Hills, CA 91301
Phone (805) 497-6979

125 Parrot Ln
Simi Valley, CA 93065
Phone (805) 584-3668

2650 Jones Way
Ste 3
Simi Valley, CA 93065
Phone (805) 584-0177

555 Marin St
Ste 290
Thousand Oaks, CA 91360
Phone (805) 497-6979

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590192000000",
    "number": "1932386877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 MARIN ST",
            "address_2": "SUITE 290",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604236",
            "telephone_number": "818-707-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MARIN ST",
            "address_2": "SUITE 290",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604236",
            "telephone_number": "818-707-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGOURA-LOS ROBLES PODIATRY CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2020-05-23",
        "certification_date": "2020-05-23",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "DARREN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "818-707-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2020; 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.