Organization Active NPI

Foot and Ankle Specialists of Michigan PLLC

  • Podiatrist
  • Berkley, MI
National Provider Identifier
1659460863
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
FOOT AND ANKLE SPECIALISTS OF MICHIGAN PLLC
Practice address
27901 Woodward Ave
Suite 110
Berkley, MI 48072-0919
Phone
(248) 545-0100
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Authorized official

Name
Cindy Smith
Title
Manager
Phone
(586) 574-0500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

27901 Woodward Ave
Suite 110
Berkley, MI 48072-0919

Mailing address

27901 Woodward Ave
Suite 110
Berkley, MI 48072-0919
Phone (248) 545-0100

Other identifiers 8

IdentifierTypeStateIssuer
CK000960OtherMILICENSE
JF001355OtherMILICENSE
LH000829OtherMILICENSE
MS000843OtherMILICENSE
5987390001OtherMIDME
DG2153OtherMIMEDICARE RAILROAD
480F335300OtherMIBCBS
480F335300OtherMIBLUECARE NETWORK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070108000157 MI Part B Supplier - Clinic/Group Practice 1153321658 Receives reassigned benefits from 7 practitioners
Practice locations: Warren, MI; Berkley, MI

National Provider Directory

National Provider Directory

Locations

29433 Ryan Rd
Warren, MI 48092
Phone (586) 574-0500

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264982400000",
    "number": "1659460863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27901 WOODWARD AVE",
            "address_2": "SUITE 110",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480720919",
            "telephone_number": "248-545-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27901 WOODWARD AVE",
            "address_2": "SUITE 110",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480720919",
            "telephone_number": "248-545-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE SPECIALISTS OF MICHIGAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-02-01",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "586-574-0500"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "CK000960",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "JF001355",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "LH000829",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MS000843",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "5987390001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DG2153",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "480F335300",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECARE NETWORK",
            "identifier": "480F335300",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.