Individual provider Active NPI

Terence Dennis Bredeweg, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Kalamazoo, MI
National Provider Identifier
1407145840
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901002416 Issued in MI
Practice address
333 Turwill LN
Kalamazoo, MI 49006-5225
Phone
(269) 373-1019
Fax
(269) 373-1669
NPI assigned
Apr 6, 2011
Last updated
Oct 15, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 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 5901002416 MI Primary

Addresses

Primary practice location

333 Turwill LN
Kalamazoo, MI 49006-5225

Mailing address

333 Turwill LN
Kalamazoo, MI 49006-5225
Phone (269) 373-1019

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
I20140520001400 MI Practitioner - Podiatry 0648401828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

305 Thomas St
Allegan, MI 49010-9158
Phone (269) 373-1019

333 Turwill LN
Kalamazoo, MI 49006-5225
Phone (269) 373-1019

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 skin lesions1-10
Removal of nail tissue496
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kalamazoo Podiatry PC Foot & Ankle Surgery CurrentSince Jul 1, 2014 Accepting new patients

Locations

305 Thomas St
Allegan, MI 49010
Phone (269) 673-2179

333 Turwill Ln
Kalamazoo, MI 49006
Phone (269) 373-1019

4310 Leonard St NW
Ste 103
Walker, MI 49534
Phone (616) 453-0600

Organizations & group practices 1

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": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413331200000",
    "number": "1407145840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 TURWILL LN",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490065225",
            "telephone_number": "269-373-1019",
            "fax_number": "269-373-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 TURWILL LN",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490065225",
            "telephone_number": "269-373-1019",
            "fax_number": "269-373-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREDEWEG",
        "first_name": "TERENCE",
        "middle_name": "DENNIS",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2014-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901002416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.