Organization Active NPI

David Basch DPM PC

  • Podiatrist
  • Sterling Heights, MI
National Provider Identifier
1679747380
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
DAVID BASCH DPM PC
Practice address
39601 Van Dyke Ave
Sterling Heights, MI 48313-4625
Phone
(586) 979-7502
Fax
(586) 979-3333
NPI assigned
Apr 15, 2008
Last updated
Oct 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Authorized official

Name
David BaschNPI 1700863313
Title
Owner
Phone
(586) 979-7502

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

39601 Van Dyke Ave
Sterling Heights, MI 48313-4625

Mailing address

39601 Van Dyke Ave
Sterling Heights, MI 48313-4625
Phone (586) 979-7502

Other identifiers 2

IdentifierTypeStateIssuer
5505022OtherMIPECAN
0330700001OtherMIDME PECAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930076402 MI DME Supplier - Physician - Podiatry 3072630797 Practice locations: Pontiac, MI
O20110128000517 MI Part B Supplier - Clinic/Group Practice 3072630797 Receives reassigned benefits from 2 practitioners
Practice locations: Pontiac, MI; Sterling Heights, MI

National Provider Directory

National Provider Directory

Locations

39601 Van Dyke Ave
Sterling Hts, MI 48313
Phone (586) 979-7502

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": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1679747380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39601 VAN DYKE AVE",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483134625",
            "telephone_number": "586-979-7502",
            "fax_number": "586-979-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39601 VAN DYKE AVE",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483134625",
            "telephone_number": "586-979-7502",
            "fax_number": "586-979-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID BASCH DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "BASCH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-979-7502"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PECAN",
            "identifier": "5505022",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PECAN",
            "identifier": "0330700001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.