Individual provider Active NPI

Michael Grimes, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Pinole, CA
National Provider Identifier
1275500720
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4413 Issued in CA
Practice address
2150 Appian Way Ste 206
Pinole, CA 94564-2520
Phone
(510) 724-1530
NPI assigned
Mar 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 1464 TX
Foot & Ankle Surgery Podiatrist 213ES0103X E4413 CA Primary

Addresses

Primary practice location

2150 Appian Way Ste 206
Pinole, CA 94564-2520

Mailing address

2150 Appian Way Ste 206
Pinole, CA 94564-2520
Phone (510) 724-1530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040826000929 CA Practitioner - Podiatry 0143295923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2150 Appian Way
Suite 206
Pinole, CA 94564-2520
Phone (510) 724-1530

Merit-based Incentive Payment System (MIPS)

Final score
44.7 of 100Reported as individual
Quality
0
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue63
Removal of skin lesions1-10
Removal of nail tissue1059
Removal or shaving of skin growth731
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4413CAMDFoot & Ankle Surgery Podiatrist
1464TXMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinole Podiatry Group Inc Foot & Ankle Surgery CurrentSince Oct 3, 2012 Accepting new patients
Lepow Podiatric Medical Associates Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
Home Foot Care, LLP Past Accepting new patients
Carolyn M. Lobo, M.D., Inc. PastSince May 10, 2020 Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients

Locations

2150 Appian Way
Ste 206
Pinole, CA 94564
Phone (510) 724-0481

1700 San Pablo Ave
Ste E
Pinole, CA 94564
Phone (510) 724-1530

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1275500720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 APPIAN WAY STE 206",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642520",
            "telephone_number": "510-724-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 APPIAN WAY STE 206",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642520",
            "telephone_number": "510-724-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "MICHAEL",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1464",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinole, CA

Sources for this page

Verify at the official NPI Registry.