NPIMap

Organization Active NPI

Foot and Ankle Associates in Patient PLLC

  • Foot & Ankle Surgery Podiatrist
  • Wyandotte, MI
National Provider Identifier
1437883295
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FOOT AND ANKLE ASSOCIATES IN PATIENT PLLC
Practice address
1628 Ford Ave
Wyandotte, MI 48192-2304
Phone
(734) 284-1333
NPI assigned
Jul 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Authorized official

Name
Basil AwawdehNPI 1619400694
Title
Ceo
Phone
(734) 284-1333

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

1628 Ford Ave
Wyandotte, MI 48192-2304

Mailing address

1628 Ford Ave
Wyandotte, MI 48192-2304

Other practice location 1

1806 N Telegraph Rd
Dearborn, MI 48128-1270
Phone (734) 284-1333

Other practice location 2

24566 Southfield Rd
Southfield, MI 48075-2711
Phone (248) 423-4220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220823000668 MI Part B Supplier - Clinic/Group Practice 2668855727 Receives reassigned benefits from 8 practitioners
Practice locations: Southfield, MI; Wyandotte, MI

National Provider Directory

National Provider Directory

Locations

1628 Ford Ave
Wyandotte, MI 48192
Phone (734) 284-1311

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1437883295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 FORD AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481922304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 FORD AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481922304",
            "telephone_number": "734-284-1333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1806 N Telegraph Rd",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481281270",
            "country_code": "US",
            "telephone_number": "734-284-1333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24566 Southfield Rd",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480752711",
            "country_code": "US",
            "telephone_number": "248-423-4220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOOT AND ANKLE ASSOCIATES IN PATIENT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-15",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "AWAWDEH",
        "authorized_official_first_name": "BASIL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "734-284-1333"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.