NPIMap

Organization Active NPI

Specialized Podiatry Services P. C.

  • Podiatrist
  • Bloomfield Hills, MI
National Provider Identifier
1184835340
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
MW000841 Issued in MI
Legal business name
SPECIALIZED PODIATRY SERVICES P. C.
Practice address
2035 Wickford CT
Bloomfield Hills, MI 48304-1088
Phone
(248) 932-2607
NPI assigned
May 26, 2007
Last updated
Jun 22, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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

Authorized official

Name
Marc Weiner, DPMNPI 1962551127
Title
President
Phone
24893226078

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
Podiatrist 213E00000X MW000841 MI Primary

Addresses

Primary practice location

2035 Wickford CT
Bloomfield Hills, MI 48304-1088

Mailing address

2035 Wickford CT
Bloomfield Hills, MI 48304-1088
Phone (248) 932-2607

Other identifiers 1

IdentifierTypeStateIssuer
MW000841OtherMISTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040825000725 MI Part B Supplier - Clinic/Group Practice 2668446501 Receives reassigned benefits from 7 practitioners
Practice locations: Bloomfield, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1180137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340323200000",
    "number": "1184835340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 WICKFORD CT",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483041088",
            "telephone_number": "248-932-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 WICKFORD CT",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483041088",
            "telephone_number": "248-932-2607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED PODIATRY SERVICES P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-26",
        "last_updated": "2012-06-22",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "24893226078",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "MW000841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MW000841",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; 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.