Pacific Coast Podiatry PC
NPI 1285080978 · Preferred Provider Organization · San Bernardino, CA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Pacific Coast Podiatry PC is a Preferred Provider Organization organization in San Bernardino, CA (NPI 1285080978).
Provider details
- NPI number
- 1285080978
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Clayton Johnsen, Owner(909) 886-3668
- License
- E4834 (CA)
Specialties & taxonomies
Managed Care Organizations
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 657 Camino De Los Mares Ste 133San Clemente, CA 92673-2810Phone: (909) 886-3668Fax: (909) 886-5542
Registry dates
- Enumerated
- 2016-05-11
- Last updated
- 2022-06-20
- Certified
- 2022-06-20
Frequently asked questions
- What is Pacific Coast Podiatry PC's NPI number?
- Pacific Coast Podiatry PC's National Provider Identifier (NPI) is 1285080978, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pacific Coast Podiatry PC?
- Pacific Coast Podiatry PC is classified in the NPPES registry as Preferred Provider Organization (Managed Care Organizations).
- Where is Pacific Coast Podiatry PC located?
- Pacific Coast Podiatry PC's practice location on file with NPPES is 1762 N Waterman Ave, San Bernardino, CA 92404-5130.
- What is Pacific Coast Podiatry PC's phone number?
- The practice phone number listed in the NPPES registry for Pacific Coast Podiatry PC is (909) 886-3668.
- Does Pacific Coast Podiatry PC accept Medicare?
- Pacific Coast Podiatry PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Pacific Coast Podiatry PC?
- The authorized official listed on Pacific Coast Podiatry PC's NPPES record is Clayton Johnsen, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pacific Coast Podiatry PC's NPI active?
- Yes — Pacific Coast Podiatry PC's NPI (1285080978) is active in the NPPES registry as of the last update on 2022-06-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.