Individual provider Active NPI

Michael Diamond, DPM

  • Podiatrist
  • University Heights, OH
National Provider Identifier
1205912193
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36002490 Issued in OH
Practice address
4501 University Pkwy
University Heights, OH 44118-3928
Phone
(216) 401-6558
Fax
(216) 932-9499
NPI assigned
Oct 31, 2006
Last updated
Dec 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36002490 OH Primary

Addresses

Primary practice location

4501 University Pkwy
University Heights, OH 44118-3928

Mailing address

4501 University Pkwy
University Heights, OH 44118-3928
Phone (216) 401-6558

Other identifiers 1

IdentifierTypeStateIssuer
0702289MedicaidOH

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20090612000065 OH Practitioner - Podiatry 1456401405 Practice locations: Parma, OH; Parma Heights, OH; Salem, OH; Solon, OH; Strongsville, OH; University Heights, OH; Warrensville Heights, OH; Westlake, OH…

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30630 Ridge Rd
Wickliffe, OH 44092-1166
Phone (440) 943-2050

4501 University Pkwy
University Heights, OH 44118-3928
Phone (216) 401-6558

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue3644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36002490OHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of the Western Reserve, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1205912193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 UNIVERSITY PKWY",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441183928",
            "telephone_number": "216-401-6558",
            "fax_number": "216-932-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 UNIVERSITY PKWY",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441183928",
            "telephone_number": "216-401-6558",
            "fax_number": "216-932-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAMOND",
        "first_name": "MICHAEL",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36002490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0702289",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in University Heights, OH

Sources for this page

Verify at the official NPI Registry.