NPIMap

Organization Active NPI

Northeastern Ohio Foot & Ankle Surgical Associates, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Battle Creek, MI
National Provider Identifier
1639235351
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36.003352 Issued in OH
Legal business name
NORTHEASTERN OHIO FOOT & ANKLE SURGICAL ASSOCIATES, INC.
Practice address
5500 Armstrong Rd
Battle Creek, MI 49037-7314
Phone
(269) 966-5600
NPI assigned
Dec 28, 2006
Last updated
Aug 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Dr. Theodore A. Buccilli Jr., DPMNPI 1164413019
Title
President
Phone
(330) 687-7464

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 36.003352 OH Primary

Addresses

Primary practice location

5500 Armstrong Rd
Battle Creek, MI 49037-7314

Mailing address

5500 Armstrong Rd
Battle Creek, MI 49037-7314
Phone (269) 966-5600

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1639235351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 ARMSTRONG RD",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490377314",
            "telephone_number": "269-966-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 ARMSTRONG RD",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490377314",
            "telephone_number": "269-966-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN OHIO FOOT & ANKLE SURGICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "BUCCILLI",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-687-7464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36.003352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.