Individual provider Active NPI

Carolyn Chun, DPM

  • Podiatrist
  • Los Angeles, CA
National Provider Identifier
1942330105
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3776 Issued in CA
Practice address
1990 Westwood Blvd Ste 220
Los Angeles, CA 90025-4674
Phone
(310) 475-5377
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E3776A CA
Foot & Ankle Surgery Podiatrist 213ES0103X E3776A CA
Foot & Ankle Surgery Podiatrist 213ES0103X E3776 CA
Foot Surgery Podiatrist 213ES0131X E3776 CA
Podiatrist 213E00000X E3776 CA Primary

Addresses

Primary practice location

1990 Westwood Blvd Ste 220
Los Angeles, CA 90025-4674

Mailing address

1990 Westwood Blvd Ste 220
Los Angeles, CA 90025-4674
Phone (310) 475-5377

Other identifiers 1

IdentifierTypeStateIssuer
000E37760MedicaidCA

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
I20110307000435 CA Practitioner - Podiatry 0042330383 Practice locations: Los Angeles, CA; Santa Monica, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1990 Westwood Blvd
Suite 220
Los Angeles, CA 90025-4674
Phone (310) 475-5377

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue12
Removal of nail tissue1493
Removal or shaving of skin growth2337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E3776ACAMDPodiatrist
E3776CAMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot & Ankle Champions Incd Foot & Ankle Surgery Past Accepting new patients
Footfix Apc Foot & Ankle Surgery PastSince Jun 9, 2018 Accepting new patients
Roohbakhsh Maher DPM. Inc Podiatrist PastSince Feb 1, 2004 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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1942330105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 WESTWOOD BLVD STE 220",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254674",
            "telephone_number": "310-475-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 WESTWOOD BLVD STE 220",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254674",
            "telephone_number": "310-475-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUN",
        "first_name": "CAROLYN",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3776A",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3776A",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3776",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E3776",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E37760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.