Individual provider Active NPI

Guercy Saint-Phard, D.P.M

  • Podiatrist
  • Benton Harbor, MI
National Provider Identifier
1689613416
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901002223 Issued in MI
Practice address
190 W Empire Ave
Benton Harbor, MI 49022-7422
Phone
(269) 926-8535
Fax
(269) 926-8528
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5901002223 MI Primary

Addresses

Primary practice location

190 W Empire Ave
Benton Harbor, MI 49022-7422

Mailing address

550 Maplewood CT. #F64
Berrien Springs, MI 49103-1381
Phone (269) 471-6835

Other identifiers 4

IdentifierTypeStateIssuer
480F37288OtherMIBCBSMI PIN
4858290MedicaidMI
4995496MedicaidMI
480006536OtherMIRAILROAD MEDICARE

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
I20060405000030 MI Practitioner - Podiatry 7517975337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

756 Pipestone St
Benton Harbor, MI 49022-4845
Phone (269) 362-2689

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
5901002223MIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Labaza Eyecare, P.C. Past Accepting new patients
Benton Harbor Health Center PLLC PastSince Sep 3, 2004 Accepting new patients

Organizations & group practices 3

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1689613416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MAPLEWOOD CT. #F64",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031381",
            "telephone_number": "269-471-6835",
            "fax_number": "269-926-8528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 W EMPIRE AVE",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490227422",
            "telephone_number": "269-926-8535",
            "fax_number": "269-926-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAINT-PHARD",
        "first_name": "GUERCY",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901002223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMI PIN",
            "identifier": "480F37288",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4858290",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4995496",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480006536",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton Harbor, MI

Sources for this page

Verify at the official NPI Registry.