Individual provider Active NPI

Michael T Ambroziak, DPM

  • Foot & Ankle Surgery Podiatrist
  • Bay City, MI
National Provider Identifier
1336105329
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901001787 Issued in MI
Practice address
3801 Wilder Rd
Bay City, MI 48706-2301
Phone
(989) 667-4663
Fax
(989) 667-1964
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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 5901001787 MI Primary

Addresses

Primary practice location

3801 Wilder Rd
Bay City, MI 48706-2301

Mailing address

111 S 3Rd St
West Branch, MI 48661-1331
Phone (989) 667-4663

Other identifiers 1

IdentifierTypeStateIssuer
3346538MedicaidMI

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
I20110226000119 MI Practitioner - Podiatry 1557356078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progress Physical Therapy IncGroup PAC ID 5698669919, 23 clinicians

Practice addresses (Care Compare)

111 S 3Rd St
West Branch, MI 48661-1331
Phone (989) 345-9774

3076 Northridge Rd
Hale, MI 48739-9277
Phone (989) 728-0242

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue22
Removal of skin lesions1-10
Removal of nail tissue762
Removal or shaving of skin growth326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Foot and Ankle Center, P.C. Foot & Ankle Surgery CurrentSince Mar 15, 1996 Accepting new patients
Family Foot and Ankle Center, P.C. Foot & Ankle Surgery CurrentSince Mar 15, 1996 Accepting new patients

Locations

3801 Wilder Rd
Ste 2
Bay City, MI 48706
Phone (517) 686-8600

111 S 3rd St
West Branch, MI 48661
Phone (989) 345-9774

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1336105329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 3RD ST",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486611331",
            "telephone_number": "989-667-4663",
            "fax_number": "989-667-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 WILDER RD",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487062301",
            "telephone_number": "989-667-4663",
            "fax_number": "989-667-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROZIAK",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901001787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3346538",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

Verify at the official NPI Registry.