PROVIDENCE PODIATRY CARE, INC
NPI 1376202986
Podiatrist - Foot & Ankle Surgery in San Bernardino, CA
About Providence Podiatry Care, Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROVIDENCE PODIATRY CARE, INC (NPI 1376202986) is a healthcare organization registered as a foot & ankle surgery in San Bernardino, California and active in the NPI registry since December 2021. The organization lists Eddie Avila, Secretary/treasuer, 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)
Providence Podiatry Care, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
15Medicare enrollment records show 15 clinicians reassign Medicare billing to Providence Podiatry Care, Inc, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 4
Clinicians, nearest first (15)
Rancho Santa Margarita, CA 92688
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 Providence Podiatry Care, Inc's NPI number?
The NPI number for Providence Podiatry Care, Inc is 1376202986. It was assigned to this organization in the NPPES registry on December 10, 2021.
Where is Providence Podiatry Care, Inc located?
Providence Podiatry Care, Inc is located at 473 E Carnegie Drive Suite 200, San Bernardino, CA 92408. The listed phone number is (909) 244-7430.
What is Providence Podiatry Care, Inc's specialty?
The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.
Is Providence Podiatry Care, Inc enrolled in Medicare?
Yes. Providence Podiatry Care, Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Providence Podiatry Care, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 15 clinicians in 4 Medicare specialties reassign their Medicare billing to Providence Podiatry Care, Inc. 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. The largest specialties are Podiatry (8), Nurse Practitioner (5) and General Surgery (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Providence Podiatry Care, Inc was last updated on June 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Providence Podiatry Care, Inc · NPI 1376202986
Foot & Ankle Surgery organization in San Bernardino, California. Organization record, active in the CMS NPPES registry since December 10, 2021.
## Identity
- **NPI:** 1376202986 (Entity type: Organization)
- **Enumerated:** December 10, 2021
- **Primary specialty:** Podiatrist - Foot & Ankle Surgery · taxonomy 213ES0103X
- **Organization subpart:** No
- **Authorized official:** Eddie Avila, SECRETARY/TREASUER
## Practice location
- **Address:** 473 E CARNEGIE DRIVE, SUITE 200, San Bernardino, CA 92408
- **Phone:** (909) 244-7430 · **Fax:** (909) 495-1380
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 15 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Podiatry (8), Nurse Practitioner (5), General Surgery (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 21, 2023
---
Source: [NPI Profile](https://npiprofile.com/npi/1376202986) · Data from the CMS NPPES public registry.