Individual provider Active NPI

Robert Patrus

  • Podiatrist
  • Saint Clair Shores, MI
National Provider Identifier
1477582955
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
RP001617 Issued in MI
Practice address
26020 Harper Ave
Saint Clair Shores, MI 48081-3773
Phone
(586) 775-1910
Fax
(586) 775-8387
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X RP001617 MI Primary

Addresses

Primary practice location

26020 Harper Ave
Saint Clair Shores, MI 48081-3773

Mailing address

26020 Harper Ave
Saint Clair Shores, MI 48081-3773
Phone (586) 775-1910

Other identifiers 2

IdentifierTypeStateIssuer
2920950MedicaidMI
485505061OtherMIBLUE CROSS BLUE SHIELD

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
I20050726000960 MI Practitioner - Podiatry 5991792285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

26020 Harper Ave
Saint Clair Shores, MI 48081-3773
Phone (586) 775-1910

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 tissue66
Removal of skin lesions1-10
Removal of nail tissue687
Removal or shaving of skin growth535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
RP001617MIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert G Patrus DPM PC Podiatrist CurrentSince May 19, 2014 Accepting new patients

Locations

3559 Pine St
Deckerville, MI 48427
Phone (810) 376-2835

22480 Kelly Rd
Ste 103
Eastpointe, MI 48021
Phone (586) 585-9119

5590 Main St
Ste 6
Lexington, MI 48450
Phone (810) 359-3937

26020 Harper Ave
St Clr Shores, MI 48081
Phone (586) 775-1910

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1477582955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26020 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813773",
            "telephone_number": "586-775-1910",
            "fax_number": "586-775-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26020 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813773",
            "telephone_number": "586-775-1910",
            "fax_number": "586-775-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRUS",
        "first_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "RP001617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2920950",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "485505061",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.