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DR. KIRMANJ TAHSIN ATRUSHI D.P.M.
NPI 1871026179
Podiatrist - Foot & Ankle Surgery in Jackson, CA

Active since April 04, 2017PECOS Enrolled
12150 NEW YORK RANCH RD, JACKSON, CA 95642(209) 257-2400(209) 257-2403 Get Directions Write a Review

NPPES record last updated: March 8, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 8, 2024, Apr 14, 2021, May 26, 2020 (3 updates tracked since 2020).

About Dr. Kirmanj Tahsin Atrushi D.p.m. NPPES

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

DR. KIRMANJ TAHSIN ATRUSHI D.P.M. (NPI 1871026179) is an individual foot & ankle surgery provider in Jackson, California, licensed in California (5968) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS and is a graduate of William M. Scholl College Of Podiatric Medicine (2017).

NPPES Registry Identity

NPI1871026179
Entity TypeIndividualMale
Primary Taxonomy213ES0103X
Provider Legal NameDR. KIRMANJ TAHSIN ATRUSHICredential: D.P.M.
Location Address12150 NEW YORK RANCH RDJackson, CA 95642-9407
Mailing AddressPo Box 939Angels Camp, CA 95222-0939 · (209) 754-6262 · Fax (209) 398-8760
Phone(209) 257-2400
Fax(209) 257-2403
Sole ProprietorNo
Medical School CMSWilliam M. Scholl College Of Podiatric MedicineGraduated 2017
Enumeration DateApril 4, 2017
Last NPPES UpdateMarch 8, 20243 updates tracked since enumeration
NPPES CertifiedMarch 8, 2024
✔ NPI 1871026179 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
Licenses✔ Licensed in CA · 5968✔ Licensed in GA · POD001442
12150 NEW YORK RANCH RD, Jackson, CA 95642
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kirmanj Tahsin Atrushi D.p.m. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7911329354
PECOS Enrollment IDI20210301002396, I20240321002694
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 Kirmanj Atrushi reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

M A C T Health Board Incorporated
15 mi
Federally Qualified Health Center (FQHC)
1113 HIGHWAY 49
San Andreas, CA 95249
  • Reassigned Medicare billing, Texas enrollment
  • 41 clinicians in this Medicare group
NPI 1366519431 (209) 755-1400
The Fort Defiance Indian Hospital Board, Incorporation
669 mi
General Acute Care Hospital
CORNER OF ROUTE N12 & N7
Fort Defiance, AZ 86504
  • Reassigned Medicare billing, Texas enrollment
  • 518 clinicians in this Medicare group
NPI 1477876639 (928) 729-8000

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

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHARON THAO VI TU DMD
Dentist (General Practice)
12150 NEW YORK RANCH RD
JACKSON, CA 95642
Amador County (209) 257-2460
LYNN CHASTAIN
Dental Hygienist
12150 NEW YORK RANCH RD
JACKSON, CA 95642
Amador County (209) 257-2460
MING-JYE YANG D.D.S.
Dentist (General Practice)
12150 NEW YORK RANCH RD
JACKSON, CA 95642
Amador County (213) 999-3019
MICHELLE PIMENTEL RDH
Dental Hygienist
12150 NEW YORK RANCH RD
JACKSON, CA 95642
Amador County (209) 257-2460
FATIMA JACOBO
Dental Hygienist
12150 NEW YORK RANCH RD
JACKSON, CA 95642
Amador County (209) 257-2400
ELIZABETH GOMEZ
Dental Hygienist
12150 NEW YORK RANCH RD
JACKSON, CA 95642
Amador County (209) 257-2460
DR. NINA TECSON DDS
Dentist (General Practice)
12150 NEW YORK RANCH RD
JACKSON, CA 95642
Amador County (209) 257-2460
HILLARY A LITTLE RDH
Dental Hygienist
12150 NEW YORK RANCH RD
JACKSON, CA 95642
Amador County (209) 754-6262

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 Kirmanj Atrushi's NPI number?

The NPI number for Kirmanj Atrushi is 1871026179. It was assigned to this individual provider in the NPPES registry on April 4, 2017.

Where is Kirmanj Atrushi located?

Kirmanj Atrushi practices at 12150 New York Ranch Rd, Jackson, CA 95642. The listed phone number is (209) 257-2400.

What is Kirmanj Atrushi's specialty?

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

Is Kirmanj Atrushi enrolled in Medicare?

Yes. Kirmanj Atrushi is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kirmanj Atrushi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kirmanj Atrushi reassigns Medicare benefits to 2 organizations: M A C T Health Board Incorporated (San Andreas, CA) and The Fort Defiance Indian Hospital Board, Incorporation (Fort Defiance, AZ). 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 Kirmanj Atrushi'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 Kirmanj Atrushi was last updated on March 8, 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.