Individual provider Active NPI

Leonard T Karadimas, DO

  • Orthopaedic Surgery Physician
  • Port Huron, MI
National Provider Identifier
1194797654
Registry record updated Mar 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
LK012026 Issued in MI
Practice address
1231 Pine Grove Ave
Suite 1a
Port Huron, MI 48060-3500
Phone
(810) 985-4300
Fax
(810) 985-9320
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X LK012026 MI Primary

Addresses

Primary practice location

1231 Pine Grove Ave
Suite 1a
Port Huron, MI 48060-3500

Mailing address

1231 Pine Grove Ave
Suite 1a
Port Huron, MI 48060-3500
Phone (810) 985-4300

Other identifiers 1

IdentifierTypeStateIssuer
3446462MedicaidMI

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060302000406 MI Practitioner - Orthopedic Surgery 4880672880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Michigan State University College of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Port HuronGroup PAC ID 9931018702, 48 clinicians

Practice addresses (Care Compare)

1163 S Carney Dr
Saint Clair, MI 48079-5569
Phone (810) 561-8450

1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 985-2663

1231 Pine Grove Ave
Port Huron, MI 48060-3500

Hospital & facility affiliations

  • Vna Home Health Care Home health agency, Port Huron, MI, CCN 237059
  • McLaren Home Health Home health agency, Clinton Township, MI, CCN 237172
  • McLaren Port Huron Hospital, Port Huron, MI, CCN 230216

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement11
Knee replacement15
Lower limb (leg) arthroscopy (minimally invasive joint repair)42
Upper limb (arm) arthroscopy (minimally invasive joint repair)22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
LK012026MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Port Huron CurrentSince Oct 1, 2017 Accepting new patients
McLaren Port Huron Current Accepting new patients
Advanced Physical Rehabilitation Karadimas PLLC Orthopaedic Surgery PastSince Feb 1, 2006 Accepting new patients
Leonard T. Karadimas,DO.,PC Orthopaedic Surgery PastSince Jul 27, 1998 Accepting new patients
Advanced Physical Rehabilitation Lukas PLLC Orthopaedic Surgery Past Accepting new patients

Locations

1231 Pine Grove Ave
Ste 1A
Port Huron, MI 48060
Phone (810) 985-4300

1163 S Carney Dr
Saint Clair, MI 48079
Phone (810) 561-8450

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
McLaren Port HuronPort Huron, MI, CCN 230216 Hospital Corporate Director Jan 1, 2022
McLaren Port HuronPort Huron, MI, CCN 23S216 Hospital Corporate Director Jan 1, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332460800000",
    "number": "1194797654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 PINE GROVE AVE",
            "address_2": "SUITE 1A",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603500",
            "telephone_number": "810-985-4300",
            "fax_number": "810-985-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 PINE GROVE AVE",
            "address_2": "SUITE 1A",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603500",
            "telephone_number": "810-985-4300",
            "fax_number": "810-985-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARADIMAS",
        "first_name": "LEONARD",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2012-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "LK012026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3446462",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.