HIGH DESERT FOOT & ANKLE CLINIC A
NPI 1104204775
Podiatrist - Foot & Ankle Surgery in Victorville, CA
About High Desert Foot & Ankle Clinic A NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HIGH DESERT FOOT & ANKLE CLINIC A (NPI 1104204775) is a healthcare organization registered as a foot & ankle surgery in Victorville, California and active in the NPI registry since May 2015. The organization lists Wonsik Y Bollmann, Owner/podiatrist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
High Desert Foot & Ankle Clinic A is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to High Desert Foot & Ankle Clinic A, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is High Desert Foot & Ankle Clinic A's NPI number?
The NPI number for High Desert Foot & Ankle Clinic A is 1104204775. It was assigned to this organization in the NPPES registry on May 14, 2015.
Where is High Desert Foot & Ankle Clinic A located?
High Desert Foot & Ankle Clinic A is located at 15366 11th St Suite A, Victorville, CA 92395. The listed phone number is (760) 951-1234.
What is High Desert Foot & Ankle Clinic A's specialty?
The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.
Is High Desert Foot & Ankle Clinic A enrolled in Medicare?
Yes. High Desert Foot & Ankle Clinic A is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through High Desert Foot & Ankle Clinic A?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in Podiatry, reassign their Medicare billing to High Desert Foot & Ankle Clinic A. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for High Desert Foot & Ankle Clinic A was last updated on June 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# High Desert Foot & Ankle Clinic A · NPI 1104204775
Foot & Ankle Surgery organization in Victorville, California. Organization record, active in the CMS NPPES registry since May 14, 2015.
## Identity
- **NPI:** 1104204775 (Entity type: Organization)
- **Enumerated:** May 14, 2015
- **Primary specialty:** Podiatrist - Foot & Ankle Surgery · taxonomy 213ES0103X
- **Organization subpart:** No
- **Authorized official:** Wonsik Bollmann, OWNER/PODIATRIST
## Practice location
- **Address:** 15366 11TH ST, SUITE A, Victorville, CA 92395-3726
- **Phone:** (760) 951-1234 · **Fax:** (760) 951-1611
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians (Podiatry) reassign Medicare billing to this organization (form CMS-855R); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 25, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1104204775) · Data from the CMS NPPES public registry.