Individual provider Active NPI

Erik Charles Kissel

  • Foot & Ankle Surgery Podiatrist
  • Warren, MI
National Provider Identifier
1285981035
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
3133154 Issued in MI
Practice address
29433 Ryan Rd
Warren, MI 48092-2203
Phone
(586) 574-0500
Fax
(586) 574-2694
NPI assigned
Aug 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 3133154 MI Primary

Addresses

Primary practice location

29433 Ryan Rd
Warren, MI 48092-2203

Mailing address

29433 Ryan Rd
Warren, MI 48092-2203
Phone (586) 574-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20141015001809 MI Practitioner - Podiatry 4082835160 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charles G Kissel DPM PCGroup PAC ID 9436167814, 9 clinicians

Practice addresses (Care Compare)

29433 Ryan Rd
Warren, MI 48092-2203
Phone (586) 574-0500

Hospital & facility affiliations

  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue84
Removal of skin lesions1-10
Removal of nail tissue414
Removal or shaving of skin growth80

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3133154MIMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Specialists of Michigan PLLC Podiatrist CurrentSince Aug 24, 2014 Accepting new patients
Charles G Kissel DPM PC Foot & Ankle Surgery CurrentSince Aug 24, 2014 Accepting new patients

Locations

27901 Woodward Ave
Ste 110
Berkley, MI 48072
Phone (248) 545-0100

39000 7 Mile Rd
Ste 2100
Livonia, MI 48152
Phone (734) 425-0060

1135 W University Dr
Ste 305
Rochester Hls, MI 48307
Phone (248) 651-0162

43200 Dequindre Rd
Ste 102
Sterling Heights, MI 48314
Phone (586) 731-8200

29433 Ryan Rd
Warren, MI 48092
Phone (586) 574-0500

Interoperability endpoints

  • Direct secure messaging: erik.kissel@cgkdp-mi.direct.office.nextgen.com
  • Direct secure messaging: ekissel1134812@direct.hfhs.org
  • Direct secure messaging: ekissel@direct.dmc.org
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1344643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1285981035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29433 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922203",
            "telephone_number": "586-574-0500",
            "fax_number": "586-574-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29433 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922203",
            "telephone_number": "586-574-0500",
            "fax_number": "586-574-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSEL",
        "first_name": "ERIK",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-11",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "3133154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.