NPIMap

Organization Active NPI

Great Lakes Foot & Ankle Institute PLLC

Doing business as Great Lakes Foot and Ankle an Anatomic Pathology Laboratory

  • Anatomic Pathology & Clinical Pathology Physician
  • Chesterfield, MI
National Provider Identifier
1417620170
Registry record updated May 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
GREAT LAKES FOOT & ANKLE INSTITUTE PLLC
Doing business as
Great Lakes Foot and Ankle an Anatomic Pathology Laboratory
Practice address
32743 23 Mile Rd Ste 110
Chesterfield, MI 48047-2082
Phone
(586) 725-3444
Fax
(586) 725-0984
NPI assigned
Jul 28, 2021
Last updated
May 17, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
GREAT LAKES FOOT & ANKLE INSTITUTE PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 17, 2025

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

Authorized official

Name
Stephen Frascone, DPMNPI 1477597961
Title
Owner
Phone
(586) 725-3444

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0101X
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X Primary
Clinical Pathology/Laboratory Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0105X

Addresses

Primary practice location

32743 23 Mile Rd Ste 110
Chesterfield, MI 48047-2082

Mailing address

9400 S Cicero Ave Ste 100
Oak Lawn, IL 60453-2536
Phone (708) 424-3201

Other names 2

  • Great Lakes Foot and Ankle an Anatomic Pathology Laboratory Doing business as
  • GREAT LAKES FOOT & ANKLE INSTITUTE PC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210811002518 MI Part B Supplier - Independent Clinical Laboratory 1557323904 Practice locations: Chesterfield, MI

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
RL Grant D Hodor PC3 organizations share this tax ID, including this one
Part of
RL Grant D Hodor PC

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747440000000",
    "number": "1417620170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 S CICERO AVE STE 100",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532536",
            "telephone_number": "708-424-3201",
            "fax_number": "708-424-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32743 23 MILE RD STE 110",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480472082",
            "telephone_number": "586-725-3444",
            "fax_number": "586-725-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES FOOT & ANKLE INSTITUTE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREAT LAKES FOOT & ANKLE INSTITUTE PLLC",
        "enumeration_date": "2021-07-28",
        "last_updated": "2025-05-17",
        "certification_date": "2025-05-17",
        "status": "A",
        "authorized_official_last_name": "FRASCONE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-725-3444",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Foot and Ankle an Anatomic Pathology Laboratory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GREAT LAKES FOOT & ANKLE INSTITUTE PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Chesterfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.