Individual provider Active NPI

Michael P Brock, DPM

  • Foot & Ankle Surgery Podiatrist
  • Harrison, OH
National Provider Identifier
1629051198
Registry record updated May 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36002705 Issued in OH
Practice address
10530 Harrison Ave
Harrison, OH 45030-2141
Phone
(513) 367-0775
Fax
(513) 367-4714
NPI assigned
Nov 29, 2005
Last updated
May 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 36002705 OH Primary

Addresses

Primary practice location

10530 Harrison Ave
Harrison, OH 45030-2141

Mailing address

9400 S Cicero Ave Ste 100
Oak Lawn, IL 60453-2536
Phone (708) 424-3201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20061006000068 OH Practitioner - Podiatry 3274539713 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
Group practices

Practice addresses (Care Compare)

1712 Race St
Cincinnati, OH 45202-6418
Phone (513) 381-2247

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue138
Removal of nail tissue478

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2705OHMDOptometrist
36002705OHMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatry Associates of Ohio Foot & Ankle Surgery CurrentSince Jan 1, 2023 Accepting new patients
Podiatry Associates of Ohio CurrentSince Jan 1, 2023 Accepting new patients
Centers for Foot & Ankle Care LLC Foot & Ankle Surgery Past Accepting new patients
Major Hospital Past Accepting new patients
Centers for Foot & Ankle Care LLC Foot & Ankle Surgery Past Accepting new patients

Locations

4650 Southwest Hwy
Oak Lawn, IL 60453
Phone (708) 424-3202

9400 S Cicero Ave
Ste 100
Oak Lawn, IL 60453
Phone (816) 673-3522

32743 23 Mile Rd
Ste 210
Chesterfield, MI 48047

8621 Winton Rd
Cincinnati, OH 45231
Phone (513) 521-2300

11560 Springfield Pike
Cincinnati, OH 45246
Phone (513) 618-9251

5315 Delhi Rd
Cincinnati, OH 45238
Phone (513) 251-4753

3035 Hamilton Mason Rd
Ste 105
Fairfield Township, OH 45011
Phone (513) 844-8585

10530 Harrison Ave
Harrison, OH 45030
Phone (513) 367-0775

10530 Harrison Ave
Ste 1
Harrison, OH 45030
Phone (513) 367-0775

Interoperability endpoints

  • Direct secure messaging: michael.brock@cffaacl-oh.direct.office.nextgen.com

Organizations & group practices 6

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747526400000",
    "number": "1629051198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 S CICERO AVE STE 100",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532536",
            "telephone_number": "708-424-3201",
            "fax_number": "708-424-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10530 HARRISON AVE",
            "city": "HARRISON",
            "state": "OH",
            "postal_code": "450302141",
            "telephone_number": "513-367-0775",
            "fax_number": "513-367-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2025-05-18",
        "certification_date": "2025-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36002705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, OH

Sources for this page

Verify at the official NPI Registry.