Foot and Ankle Specialty Clinic

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

5901002122 Issued in MI

Legal business name

FOOT AND ANKLE SPECIALTY CLINIC

Practice address

5525 Schaefer Rd
Dearborn, MI 48126-3253

Phone

(313) 846-9717

Fax

(313) 846-9805

NPI assigned

Sep 25, 2007

Last updated

Mar 22, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Summer Tourfa

Title

Office Manager

Phone

(313) 846-9717

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

Locations

Practitioners 1

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.

• Bilal E Ismail, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Dearborn, MI
  • NPI 1538135835
  Medicare reassignment NPD

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363910400000",
    "number": "1205023033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263253",
            "telephone_number": "313-846-9717",
            "fax_number": "313-846-9805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263253",
            "telephone_number": "313-846-9717",
            "fax_number": "313-846-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE SPECIALTY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2013-03-22",
        "status": "A",
        "authorized_official_last_name": "TOURFA",
        "authorized_official_first_name": "SUMMER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "313-846-9717",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901002122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4858213650",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4849095",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECARE NETWORK",
            "identifier": "4858213650",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Dearborn, MI
• Providers in Dearborn, 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 Mar 22, 2013; 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.