Providence Podiatry Care, Inc
NPI 1376202986ActiveOrganization· Podiatrist, Foot & Ankle Surgery· San Bernardino, CA
Podiatrist, Foot & Ankle Surgery in San Bernardino, California, registered in NPPES in December 2021. The authorized official on file is Eddie Avila, Secretary/Treasuer. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1376202986 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 10, 2021 |
| Last updated in NPPES | Jun 21, 2023 |
| Certified by provider | Jun 7, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Podiatrist, Foot & Ankle Surgery Primary | 213ES0103X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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