Individual provider Active NPI

Mafutaga S. Tagaloa-Tulifau, D.P.M.

  • Podiatrist
  • Lakewood, CA
National Provider Identifier
1962435594
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4193 Issued in CA
Practice address
5220 Clark Ave
Suite 315
Lakewood, CA 90712-2618
Phone
(562) 925-3055
Fax
(562) 925-7371
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4193 CA Primary

Addresses

Primary practice location

5220 Clark Ave
Suite 315
Lakewood, CA 90712-2618

Mailing address

5220 Clark Ave
Suite 315
Lakewood, CA 90712-2618
Phone (562) 925-3055

Other identifiers 1

IdentifierTypeStateIssuer
000E41930MedicaidCA

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
I20100816000527 CA Practitioner - Podiatry 1951435734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5220 Clark Ave
Suite 315
Lakewood, CA 90712-2635
Phone (562) 925-3055

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue280
Removal or shaving of skin growth147
Skin biopsy16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tagaloa-Tulifau Foot and Ankle Center, Inc. CurrentSince Aug 9, 2018 Accepting new patients
Tagaloa-Tulifau Foot and Ankle Center, Inc. Podiatrist PastSince Sep 29, 2024 Accepting new patients
Dr. Mafutaga S. Tagaloa-Tulifau PastSince Jan 1, 2008 Accepting new patients

Locations

23517 Main St
Ste 105
Carson, CA 90745
Phone (424) 450-0950

5220 Clark Ave
Ste 315
Lakewood, CA 90712
Phone (562) 925-3055

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1962435594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 CLARK AVE",
            "address_2": "SUITE 315",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907122618",
            "telephone_number": "562-925-3055",
            "fax_number": "562-925-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 CLARK AVE",
            "address_2": "SUITE 315",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907122618",
            "telephone_number": "562-925-3055",
            "fax_number": "562-925-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGALOA-TULIFAU",
        "first_name": "MAFUTAGA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E41930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

Verify at the official NPI Registry.