Organization Active NPI

GFC of Southeastern Michigan, PC

  • Foot & Ankle Surgery Podiatrist
  • Detroit, MI
National Provider Identifier
1316191679
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901002275 Issued in MI
Legal business name
GFC OF SOUTHEASTERN MICHIGAN, PC
Practice address
4160 John R St Ste 1011
Detroit, MI 48201-2017
Phone
(313) 833-3090
Fax
(313) 833-7843
NPI assigned
Nov 12, 2008
Last updated
Dec 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Authorized official

Name
Dr. Manisha Mehta, DPMNPI 1417136029
Title
Physician
Phone
(313) 833-3090

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X
Foot & Ankle Surgery Podiatrist 213ES0103X 5901002275 MI Primary

Addresses

Primary practice location

4160 John R St Ste 1011
Detroit, MI 48201-2017

Mailing address

4160 John R St Ste 111
Detroit, MI 48201-2021
Phone (313) 833-3090

Other identifiers 3

IdentifierTypeStateIssuer
1417136029MedicaidMI
82028141OtherMIPROCARE
1316191679OtherMIMEDICARE NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081230000193 MI Part B Supplier - Clinic/Group Practice 6507928504 Receives reassigned benefits from 2 practitioners
Practice locations: Detroit, MI
O20100930012010 MI DME Supplier - Physician - Podiatry 6507928504 Practice locations: Detroit, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2199088GFC of Southeastern Michigan, PC4160 John R Suite 1011, Detroit, MI 48201Certificate of waiverNov 4, 2026

National Provider Directory

National Provider Directory
Tax ID family
Gentle Foot Care of Western Ohio3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

15 E Kirby St
Ste 102
Detroit, MI 48202
Phone (313) 833-3090

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1316191679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST STE 111",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012021",
            "telephone_number": "313-833-3090",
            "fax_number": "313-833-7843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST STE 1011",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012017",
            "telephone_number": "313-833-3090",
            "fax_number": "313-833-7843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GFC OF SOUTHEASTERN MICHIGAN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-12",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "MANISHA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "313-833-3090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901002275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417136029",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROCARE",
            "identifier": "82028141",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1316191679",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.