Organization Active NPI

Robert G Patrus DPM PC

  • Podiatric Clinic/Center
  • Saint Clair Shores, MI
National Provider Identifier
1164855490
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
ROBERT G PATRUS DPM PC
Practice address
26020 Harper Ave
Saint Clair Shores, MI 48081-3773
Phone
(586) 775-1910
Fax
(586) 775-8387
NPI assigned
Aug 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Authorized official

Name
Dr. Robert Patrus, DPMNPI 1477582955
Title
Doctor
Phone
(586) 775-1910

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X Primary

Addresses

Primary practice location

26020 Harper Ave
Saint Clair Shores, MI 48081-3773

Mailing address

26020 Harper Ave
Saint Clair Shores, MI 48081-3773
Phone (586) 775-1910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131223000253 MI DME Supplier - Physician - PodiatryDME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 9234366121 Practice locations: Saint Clair Shores, MI
O20140506000930 MI Part B Supplier - Clinic/Group Practice 9234366121 Receives reassigned benefits from 1 practitioner
Practice locations: Lexington, MI; Saint Clair Shores, MI; Deckerville, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Robert G Patrus DPM PC26020 Harper Ave, Saint Clair Shores, MI 48081-3773(586) 775-1910 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Oct 15, 2013

National Provider Directory

National Provider Directory

Locations

26020 Harper Ave
St Clr Shores, MI 48081
Phone (586) 775-1910

22125 Greater Mack Ave
St Clr Shores, MI 48080
Phone (586) 498-1500

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": "1376006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1164855490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26020 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813773",
            "telephone_number": "586-775-1910",
            "fax_number": "586-775-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26020 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813773",
            "telephone_number": "586-775-1910",
            "fax_number": "586-775-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT G PATRUS DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-09",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "PATRUS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "586-775-1910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.