Thomas Bruce De Korte, DPM
Individual provider Active NPI Podiatrist · Charlevoix, MI
NPI 1639259237 · NPPES record last updated Nov 28, 2007
Key facts
- NPI
- 1639259237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Podiatrist 213E00000X
- License
- TD001078 (MI)
- Practice address
- 1404 Bridge St
Charlevoix, MI 49720-2603 - Phone
- (231) 547-4662
- Fax
- (231) 547-3068
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1404 Bridge St
Charlevoix, MI 49720-2603
Phone (231) 547-4662
14676 W Upright St
Charlevoix, MI 49720-1201
Phone (231) 547-1005
1662 S Otsego Ave
Gaylord, MI 49735-8379
Phone (989) 732-6565
1728 S Peninsula Rd
East Jordan, MI 49727-9410
Phone (231) 536-2286
4310 Leonard St NW
Suite 103
Walker, MI 49534-8447
5520 Kuzmick Rd
Elmira, MI 49730-9534
Phone (989) 732-7389
615 Petoskey Ave
Charlevoix, MI 49720-1291
Phone (231) 547-2599
825 N Ctr St
Gaylord, MI 49735-1592
Phone (989) 731-2131
965 Hager Dr
Petoskey, MI 49770-8784
Phone (231) 348-8498
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 57 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1917 |
| Removal or shaving of skin growth | 537 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080205000298 | MI | Practitioner - Podiatry | 1658453238 | Practice locations: Eastport, MI; Elmira, MI; Gaylord, MI; Petoskey, MI; Traverse City, MI; Boyne City, MI; Vanderbilt, MI; East Jordan, MI… |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TD001078 | MI | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Geoffrey M Day DPM PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | TD001078 | MI | Yes |
Addresses
Primary practice location
1404 Bridge St
Charlevoix, MI 49720-2603
Mailing address
PO Box 103
1404 Bridge Street
Charlevoix, MI 49720-0103
Phone (231) 547-4662
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1441583 | Medicaid | MI | |
| 5155000 | Other | MI | BLUE CROSS |
Other providers in Charlevoix, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.