Organization Active NPI

Northfield Podiatry Associates P C

  • Podiatrist
  • Grand Rapids, MI
National Provider Identifier
1124182456
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901001390 Issued in MI
Legal business name
NORTHFIELD PODIATRY ASSOCIATES P C
Practice address
2501 Plainfield Ave NE
Suite C
Grand Rapids, MI 49505-3700
Phone
(616) 364-8495
Fax
(616) 364-1955
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Authorized official

Name
Martin G Hoffmeister, D.P.M.NPI 1699839365
Title
Vice President
Phone
(616) 364-8495

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 5901001390 MI Primary
Prosthetic/Orthotic Supplier 335E00000X 5901001390 MI

Addresses

Primary practice location

2501 Plainfield Ave NE
Suite C
Grand Rapids, MI 49505-3700

Mailing address

2501 Plainfield Ave NE
Suite C
Grand Rapids, MI 49505-3700
Phone (616) 364-8495

Other identifiers 1

IdentifierTypeStateIssuer
MH001390OtherPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101013000363 MI Part B Supplier - Clinic/Group Practice 2062604713 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Locations

2501 Plainfield Ave NE
Ste C
Grand Rapids, MI 49505
Phone (616) 364-8495

2501 Plainfield Ave NE
Grand Rapids, MI 49505
Phone (616) 363-6612

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1124182456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 PLAINFIELD AVE NE",
            "address_2": "SUITE C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053700",
            "telephone_number": "616-364-8495",
            "fax_number": "616-364-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 PLAINFIELD AVE NE",
            "address_2": "SUITE C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053700",
            "telephone_number": "616-364-8495",
            "fax_number": "616-364-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHFIELD PODIATRY ASSOCIATES P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "HOFFMEISTER",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "616-364-8495",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001390",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MI",
            "license": "5901001390",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "MH001390",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.