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MADISON RAVINE DPM
NPI 1679102800
Podiatrist - Foot & Ankle Surgery in San Diego, CA

Active since April 08, 2020PECOS EnrolledAccepts Medicare Assignment
3405 KENYON ST STE 502, SAN DIEGO, CA 92110(619) 225-9601 Get Directions Write a Review

NPPES record last updated: March 6, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 6, 2024, Jun 22, 2020, Apr 8, 2020 (3 updates tracked since 2020).

About Madison Ravine Dpm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MADISON RAVINE DPM (NPI 1679102800) is an individual foot & ankle surgery provider in San Diego, California, licensed in Massachusetts (1516) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS, maintains a secondary practice location in Cambridge, and is a graduate of California School Of Podiatric Medicine (2020).

NPPES Registry Identity

NPI1679102800
Entity TypeIndividualFemale
Primary Taxonomy213ES0103X
Provider Legal NameMADISON RAVINECredential: DPM
Location Address3405 KENYON ST STE 502San Diego, CA 92110-5008
Mailing Address3405 Kenyon St Ste 502San Diego, CA 92110-5008
Phone(619) 225-9601
Sole ProprietorNo
Medical School CMSCalifornia School Of Podiatric MedicineGraduated 2020
Enumeration DateApril 8, 2020
Last NPPES UpdateMarch 6, 20243 updates tracked since enumeration
NPPES CertifiedMarch 6, 2024
✔ NPI 1679102800 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in MA · 1516
3405 KENYON ST STE 502, San Diego, CA 92110
Open in Google Maps ↗

Secondary Practice Location 1

Location 11493 Cambridge StCambridge, MA 02139-1047 · Phone (617) 665-1000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Madison Ravine Dpm is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1153782677
PECOS Enrollment IDI20230801001199
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Madison Ravine reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sports Arena Podiatry Group Inc
0.4 mi
Podiatrist
3340 KEMPER ST, STE 102
San Diego, CA 92110
  • Reassigned Medicare billing, California enrollment
  • 3 clinicians in this Medicare group
NPI 1225004435 (619) 225-9601
Emergency And Acute Care Medical Corporation
5.0 mi
Emergency Medicine
7901 FROST ST
San Diego, CA 92123
  • Reassigned Medicare billing, California enrollment
  • 1,437 clinicians in this Medicare group
NPI 1437103942 (858) 939-3400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
99 services99 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
94 services64 patients
Removal of fingernails or toenails, 6 or more nails 11721
This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.
68 services28 patients
Removal of noncancer thickened skin growth, 2-4 growths 11056
This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.
47 services26 patients
Removal of noncancer thickened skin growth, 1 growth 11055
This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.
22 services16 patients
X-ray of foot, minimum of 3 views 73630
An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.
18 services16 patients

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 Madison Ravine's NPI number?

The NPI number for Madison Ravine is 1679102800. It was assigned to this individual provider in the NPPES registry on April 8, 2020.

Where is Madison Ravine located?

Madison Ravine practices at 3405 Kenyon St Ste 502, San Diego, CA 92110. The listed phone number is (619) 225-9601.

What is Madison Ravine's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Madison Ravine enrolled in Medicare?

Yes. Madison Ravine is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Madison Ravine's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Madison Ravine reassigns Medicare benefits to 2 organizations: Sports Arena Podiatry Group Inc (San Diego, CA) and Emergency And Acute Care Medical Corporation (San Diego, CA). Each 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 Madison Ravine's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Madison Ravine was last updated on March 6, 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.