Active NPI
Alexander Icardi, DPM
- Podiatrist
- Warren, MI
National Provider Identifier
1477049260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 5901002742
- Practice address
- 21230 Dequindre Rd
Warren, MI 48091-2279 - Phone
- (586) 427-1000
- NPI assigned
- Jul 5, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 5901002742 | MI | Primary |
Addresses
Primary practice location
21230 Dequindre Rd
Warren, MI 48091-2279
Mailing address
21230 Dequindre Rd
Warren, MI 48091-2279
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5901002742 | MI | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530748800000",
"number": "1477049260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21230 DEQUINDRE RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480912279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21230 DEQUINDRE RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480912279",
"telephone_number": "586-427-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ICARDI",
"first_name": "ALEXANDER",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-05",
"last_updated": "2018-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MI",
"license": "5901002742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.