Great Lakes Podiatry PLLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

GREAT LAKES PODIATRY PLLC

Practice address

126 S 25TH St
Suite a
Escanaba, MI 49829-1364

Phone

(906) 786-2385

Fax

(906) 789-4445

NPI assigned

Jun 10, 2006

Last updated

Mar 12, 2026By 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

Mary Pat Leveille

Title

Practice Manager

Phone

(906) 280-5396

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

Tax ID family

Great Lakes Podiatry PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Great Lakes Podiatry PLLC

  • Durable Medical Equipment & Medical Supplies
  • Escanaba, MI
  • NPI 1043728553
  NPD tax ID

Locations

Practitioners 8

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.

• Jake Eisenschink, DPM

  • Foot & Ankle Surgery Podiatrist
  • Escanaba, MI
  • NPI 1194286997

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Dennis W Leveille, DPM

  • Foot & Ankle Surgery Podiatrist
  • Escanaba, MI
  • NPI 1982696209
  Medicare reassignment Care Compare group NPD
• Rachelle Lynn Leveille, DPM

  • Foot & Ankle Surgery Podiatrist
  • Escanaba, MI
  • NPI 1629631965
  Medicare reassignment Care Compare group NPD
• Adina-Maria Anderson, DPM

  • Podiatrist
  • Iron Mountain, MI
  • NPI 1730136672
  NPD (past)
• Laura M Lamar, DPM

  • Foot & Ankle Surgery Podiatrist
  • Chesterfield, MI
  • NPI 1881687853
  NPD (past)
• Michael E Zevitz, M.D.

  • Internal Medicine Physician
  • Norway, MI
  • NPI 1871543843
  NPD (past)
• Laurie S Broghammer, DPM

  • Podiatrist
  • Winona, MN
  • NPI 1891705505
  NPD (past)
• Craig T Jex, DPM

  • Foot & Ankle Surgery Podiatrist
  • Tehachapi, CA
  • NPI 1558455162
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773273600000",
    "number": "1225079932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 S 25TH ST STE A",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291364",
            "telephone_number": "906-786-2385",
            "fax_number": "877-276-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 S 25TH ST",
            "address_2": "SUITE A",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291364",
            "telephone_number": "906-786-2385",
            "fax_number": "906-789-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PODIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A",
        "authorized_official_last_name": "LEVEILLE",
        "authorized_official_first_name": "MARY PAT",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "906-280-5396"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4729159",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ariane Grandchamp, PHARMD
• Patrick J Grandchamp
• Stephanie Marie Gravelle
• Great Lakes Gynecology & Aesthetics Inc, PC
• Great Lakes Podiatry PLLC
• Great Lakes Recovery Centers
• Great Lakes Recovery Centers
• Great Northern Dental Assoc PC
• Great Smile Dentistry
• Greenlund Enterprises, Inc

• Podiatrist in Escanaba, MI
• Providers in Escanaba, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.