Gretta Shara, DPM

Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Armada, MI

NPI 1679535942 · NPPES record last updated Oct 6, 2008

Key facts

NPI
1679535942
Entity type
Individual (NPI type 1)
Primary specialty
Foot & Ankle Surgery Podiatrist 213ES0103X
License
5901001789 (MI)
Practice address
23064 E Main St
Armada, MI 48005-4705
Phone
(586) 784-0184
Fax
(586) 784-5227
NPI assigned
Apr 4, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23064 E Main St
Armada, MI 48005-4705
Phone (586) 784-0184

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions21
Removal of nail tissue51
Removal or shaving of skin growth35

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 IDStateProvider typePAC IDDetails
I20060411000591 MI Practitioner - Podiatry 8921017427 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Gretta Shara, DPM, PC Podiatrist Current
since Jul 14, 1995
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5901001789 MI
Foot & Ankle Surgery Podiatrist 213ES0103X 5901001789 MI Yes

Addresses

Primary practice location

23064 E Main St
Armada, MI 48005-4705

Mailing address

PO Box 907
Armada, MI 48005-0907
Phone (586) 784-0184

Other identifiers

IdentifierTypeStateIssuer
P00301345OtherMIMEDICARE RAILROAD PIN
4855001230OtherMIBLUE CROSS BLUE SHIELD
383335188OtherMICOMERCIAL

Other providers in Armada, MI

All providers in Armada, MI · Foot & Ankle Surgery Podiatrist in Michigan

Sources for this page

Verify at the official NPI Registry.