Individual provider Active NPI

Ghassan Ateyah, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Troy, MI
National Provider Identifier
1457703597
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901002654 Issued in MI
Practice address
1607 E Big Beaver Rd Ste 110
Troy, MI 48083-2067
Phone
(586) 434-3444
Fax
(586) 434-3445
NPI assigned
Jul 12, 2016
Last updated
Jan 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901002654 MI Primary
Foot Surgery Podiatrist 213ES0131X 5901002654 MI

Addresses

Primary practice location

1607 E Big Beaver Rd Ste 110
Troy, MI 48083-2067

Mailing address

1607 E Big Beaver Rd Ste 110
Troy, MI 48083-2067
Phone (586) 434-3444

Other identifiers 1

IdentifierTypeStateIssuer
23-0264MedicaidMI

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190611003484 MI Practitioner - PodiatryPractitioner - Pain Management 4284967936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PodiatryAlso: Pain Management
Education
New York College of Podiatric Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mini Invasive Podiatry PLCGroup PAC ID 3375876022, 3 clinicians

Practice addresses (Care Compare)

1607 E Big Beaver Rd
Suite 110
Troy, MI 48083-2067
Phone (586) 434-3444

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue63
Removal of skin lesions32
Removal of nail tissue241
Removal or shaving of skin growth203
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mini Invasive Podiatry PLC Podiatrist CurrentSince Nov 1, 2018 Accepting new patients
Mini Invasive Podiatry PLC Foot & Ankle Surgery CurrentSince Jul 1, 2019 Accepting new patients

Locations

3058 Metropolitan Pkwy
Ste 206
Sterling Heights, MI 48310
Phone (586) 303-6195

1607 E Big Beaver Rd
Ste 110
Troy, MI 48083
Phone (586) 303-6195

Interoperability endpoints

  • Direct secure messaging: gateyah@mipp-mi.direct.office.nextgen.com
  • Direct secure messaging: gateyah1115578@direct.hfhs.org
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1457703597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 E BIG BEAVER RD STE 110",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480832067",
            "telephone_number": "586-434-3444",
            "fax_number": "586-434-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 E BIG BEAVER RD STE 110",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480832067",
            "telephone_number": "586-434-3444",
            "fax_number": "586-434-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATEYAH",
        "first_name": "GHASSAN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-12",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901002654",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MI",
            "license": "5901002654",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23-0264",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.