Individual provider Active NPI

Michael W Krupic, DPM

  • Podiatrist
  • Southfield, MI
National Provider Identifier
1093754244
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901002111 Issued in MI
Practice address
22972 Lahser Rd
Southfield, MI 48033-4408
Phone
(248) 353-0096
Fax
(248) 353-4235
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5901002111 MI Primary

Addresses

Primary practice location

22972 Lahser Rd
Southfield, MI 48033-4408

Mailing address

22972 Lahser Rd
Southfield, MI 48033-4408
Phone (248) 735-3009

Other identifiers 1

IdentifierTypeStateIssuer
4653963MedicaidMI

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
I20040924000980 MI Practitioner - Podiatry 6002884533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louis J Geller DPM PCGroup PAC ID 2264502665, 5 clinicians

Practice addresses (Care Compare)

28460 Southfield Rd
Lathrup Village, MI 48076-2820
Phone (248) 353-0096

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Procedures performed for Medicare patients

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Institute of Michigan PLLC Podiatrist Past Accepting new patients
Foot & Ankle Health Center PC Past Accepting new patients

Organizations & group practices 3

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

Hospital & facility affiliations 3

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325030400000",
    "number": "1093754244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22972 LAHSER RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334408",
            "telephone_number": "248-735-3009",
            "fax_number": "248-353-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22972 LAHSER RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334408",
            "telephone_number": "248-353-0096",
            "fax_number": "248-353-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUPIC",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901002111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4653963",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.