Individual provider Active NPI

Gary L Stano, DPM

  • Podiatrist
  • Southfield, MI
National Provider Identifier
1669489449
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901001470 Issued in MI
Practice address
24445 Northwestern Hwy
Suite 206
Southfield, MI 48075-6501
Phone
(248) 799-0086
Fax
(248) 350-1178
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5901001470 MI Primary

Addresses

Primary practice location

24445 Northwestern Hwy
Suite 206
Southfield, MI 48075-6501

Mailing address

24445 Northwestern Hwy
Suite 206
Southfield, MI 48075-6501
Phone (248) 799-0086

Other identifiers 2

IdentifierTypeStateIssuer
5184125MedicaidMI
4856315900OtherMIBLUE CROSS BLUE SHIELD

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
I20050713000931 MI Practitioner - Podiatry 8123054871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Traveling Physician Services PCGroup PAC ID 5395253322, 3 clinicians

Practice addresses (Care Compare)

18000 W 9 Mile Rd
Suite 525
Southfield, MI 48075-4080
Phone (248) 327-6196

Merit-based Incentive Payment System (MIPS)

Final score
93.77 of 100Reported as apm
Quality
75.13
Promoting interoperability
88.5
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue707
Removal or shaving of skin growth340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5901001470MIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Traveling Physician Services PC CurrentSince Jun 14, 2025 Accepting new patients
Integrated Visiting Physician Solutions PC CurrentSince Feb 14, 2017 Accepting new patients
First Ideal Enterprises Inc. Podiatrist Past Accepting new patients
Embrace Home Physicians PLLC PastSince Nov 21, 2016 Accepting new patients
Positive Home Doctors, PC PastSince Jun 1, 2004 Accepting new patients

Locations

18000 W 9 Mile Rd
Ste 525
Southfield, MI 48075
Phone (248) 327-6195

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1669489449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24445 NORTHWESTERN HWY",
            "address_2": "SUITE 206",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756501",
            "telephone_number": "248-799-0086",
            "fax_number": "248-350-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24445 NORTHWESTERN HWY",
            "address_2": "SUITE 206",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756501",
            "telephone_number": "248-799-0086",
            "fax_number": "248-350-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANO",
        "first_name": "GARY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5184125",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4856315900",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.