Organization Active NPI

Sore Feet Podiatry PC

  • Podiatrist
  • Royal Oak, MI
National Provider Identifier
1225323579
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
RB001223 Issued in MI
Legal business name
SORE FEET PODIATRY PC
Practice address
32432 Woodward Ave
Royal Oak, MI 48073-0947
Phone
(313) 274-7047
Fax
(313) 274-7032
NPI assigned
Jun 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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

Authorized official

Name
Dr. Randy Harvey Bernstein, DPMNPI 1710069729
Title
Owner
Phone
(313) 274-7047

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X RB001223 MI Primary

Addresses

Primary practice location

32432 Woodward Ave
Royal Oak, MI 48073-0947

Mailing address

32432 Woodward Ave
Royal Oak, MI 48073-0947
Phone (313) 274-7047

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120222000103 MI Part B Supplier - Clinic/Group Practice 0749448702 Receives reassigned benefits from 4 practitioners
Practice locations: Royal Oak, MI

National Provider Directory

National Provider Directory

Locations

32432 Woodward Ave
Royal Oak, MI 48073
Phone (248) 549-2500

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308096000000",
    "number": "1225323579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32432 WOODWARD AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730947",
            "telephone_number": "313-274-7047",
            "fax_number": "313-274-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32432 WOODWARD AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730947",
            "telephone_number": "313-274-7047",
            "fax_number": "313-274-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SORE FEET PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-15",
        "last_updated": "2011-06-15",
        "status": "A",
        "authorized_official_last_name": "BERNSTEIN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "HARVEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-274-7047",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "RB001223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.