Brian George Loder, DPM, CWS

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

BL001662 Issued in MI

Practice address

43391 Commons Dr
Clinton Township, MI 48038-1109

Phone

(586) 329-3895

Fax

(586) 329-3916

NPI assigned

Jun 16, 2005

Last updated

Nov 17, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 12

Electronic endpoints 1

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

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brian G. Loder DPM PLCGroup PAC ID 5698823441, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bloder5027@direct.hfhs.org

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.

• Brian G. Loder DPM PLC

  • Foot & Ankle Surgery Podiatrist
  • Clinton TWP, MI
  • NPI 1508004920
  Medicare reassignment Care Compare group NPD Authorized official
• Comprehensive Wound Care Center of Michigan PLLC

  • Primary Podiatric Medicine Podiatrist
  • Clinton Township, MI
  • NPI 1295621209
  Authorized official Same address or phone
• Minimal Invasive Surgery Center PLC

  • Ambulatory Surgical Clinic/Center
  • Clinton Township, MI
  • NPI 1497582274
  Authorized official Same address or phone
• Michigan Foot & Ankle Institute PC

  • Podiatrist
  • Clinton Township, MI
  • NPI 1427083492

  Foot & Ankle Surgery

  NPD (past)

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

• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Health Macomb Hospital

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1902842735
  Care Compare affiliation
• William Beaumont Hospital

  dba Beaumont Hospital, Troy

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1184629180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15760 19 MILE RD STE E",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386319",
            "telephone_number": "586-329-3895",
            "fax_number": "586-329-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43391 COMMONS DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381109",
            "telephone_number": "586-329-3895",
            "fax_number": "586-329-3916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15760 19 Mile Rd Ste E",
            "address_purpose": "LOCATION",
            "city": "Clinton Township",
            "state": "MI",
            "postal_code": "480386319",
            "country_code": "US",
            "telephone_number": "586-329-3895",
            "fax_number": "586-329-3916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LODER",
        "first_name": "BRIAN",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DPM, CWS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "BL001662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00777182",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4616745",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4638660",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "C3980",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLNESS",
            "identifier": "10040760007",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HEALTH PLAN",
            "identifier": "101706",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED/CARE CHOICES",
            "identifier": "107320",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "4855057230",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "4616745",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "4855057230",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "U53759",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "234010003",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "endpointDescription": "EPIC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "43391 Commons Dr",
            "city": "Clinton Township",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480381109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jack Lipscomb
• April Cheri Little, PTA
• Sandrella Lo Grasso, PHYSICAL THERAPIST
• Amanda L Locke, MA, LLPC
• Elzbieta Lodej
• Kaitlyn Loewen
• Vanessa Loftis
• Lorenzo Lograsso, OD
• Taylor Lohrmann, LLMSW
• Kelvin Loke, DO

• Foot & Ankle Surgery Podiatrist in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Foot & Ankle Surgery Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.