Dr Andy Archuleta, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Lodi, California. His current practice location is
1300 W Lodi Ave Ste W, Lodi, California. You can reach out to his office (for appointments etc.) via phone at
(209) 334-6664.
Dr Andy Archuleta is licensed to practice in California (license number E5929) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1407417744.
Healthcare Provider's Profile
| Full Name | Dr Andy Archuleta |
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| Gender | Male |
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| Speciality | Podiatrist - Foot & Ankle Surgery |
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| Location | 1300 W Lodi Ave Ste W, Lodi, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1407417744
- Provider Enumeration Date: 06/26/2019
- Last Update Date: 07/27/2023
Medicare PECOS Information:
- PECOS PAC ID: 5395103683
- Enrollment ID: I20230619001190
Medical Identifiers
Medical identifiers for Dr Andy Archuleta such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1407417744 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213ES0103X | Podiatrist - Foot & Ankle Surgery | E5929 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Andy Archuleta allows following entities to bill medicare on his behalf.
| Provider Name | Lodi Podiatry Group |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1750360699
PECOS PAC ID: 4789709262
Enrollment ID: O20100921000933 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Andy Archuleta is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Andy Archuleta, DPM
12303 De Paul Dr,
Bridgeton, MO 63044-2512
Ph: () - | Dr Andy Archuleta, DPM
1300 W Lodi Ave Ste W,
Lodi, CA 95242-3037
Ph: (209) 334-6664 |
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