Individual provider Active NPI

Gary Mauro, DPM

  • Podiatrist
  • Warren, MI
National Provider Identifier
1033109178
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0844 Issued in MI
Practice address
3701 E 13 Mile Rd
Warren, MI 48092-3790
Phone
(586) 979-1060
NPI assigned
Oct 27, 2005
Last updated
May 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0844 MI Primary

Addresses

Primary practice location

3701 E 13 Mile Rd
Warren, MI 48092-3790

Mailing address

3701 E 13 Mile Rd
Warren, MI 48092-3790
Phone (586) 979-1060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111222000557 MI Practitioner - Podiatry 3476640467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Warren Podiatry PCGroup PAC ID 4486741477, 5 clinicians

Practice addresses (Care Compare)

3701 E 13 Mile Rd
Suite a
Warren, MI 48092-3795
Phone (586) 979-1060

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions34
Removal of nail tissue122
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0844MIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Podiatry, PC Podiatrist CurrentSince Oct 1, 1993 Accepting new patients

Locations

3701 E 13 Mile Rd
Warren, MI 48092
Phone (586) 758-0123

3701 E 13 Mile Rd
Ste A
Warren, MI 48092
Phone (586) 979-1060

Interoperability endpoints

  • Direct secure messaging: gmauro1140590@direct.hfhs.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1033109178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 E 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480923790",
            "telephone_number": "586-979-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 E 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480923790",
            "telephone_number": "586-979-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURO",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "0844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.