Individual provider Active NPI

Herman Zicherman, DPM

  • Podiatrist
  • Lake Orion, MI
National Provider Identifier
1588752265
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000972 Issued in MI
Practice address
3268 Yosemite Dr
Lake Orion, MI 48360-1034
Phone
(248) 763-0111
NPI assigned
Oct 10, 2006
Last updated
Oct 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 000972 MI Primary

Addresses

Primary practice location

3268 Yosemite Dr
Lake Orion, MI 48360-1034

Mailing address

1500 Weiss St
Saginaw, MI 48602-5251
Phone (989) 293-1978

Other identifiers 1

IdentifierTypeStateIssuer
1409648MedicaidMI

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
I20091123000331 MI Practitioner - Podiatry 2365581881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1848FLMDOptician
000972MIMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1588752265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 WEISS ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025251",
            "telephone_number": "989-293-1978",
            "fax_number": "313-341-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3268 YOSEMITE DR",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601034",
            "telephone_number": "248-763-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZICHERMAN",
        "first_name": "HERMAN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "000972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1409648",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Orion, MI

Sources for this page

Verify at the official NPI Registry.