Individual provider Active NPI

Michael P. Regan, DPM

  • Foot & Ankle Surgery Podiatrist
  • Dayton, OH
National Provider Identifier
1699767269
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36002164R Issued in OH
Practice address
425 W Grand Ave Ste 3002
Dayton, OH 45405-4722
Phone
(937) 723-4231
Fax
(937) 734-4170
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 36002164R OH Primary

Addresses

Primary practice location

425 W Grand Ave Ste 3002
Dayton, OH 45405-4722

Mailing address

PO Box 1022
Dayton, OH 45401-1022
Phone (937) 221-8555

Other identifiers 2

IdentifierTypeStateIssuer
0530527MedicaidOH
4280581OtherOHMEDICARE PTAN NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20031229000066 OH Practitioner - Podiatry 9032017199 Practice locations: Dayton, OH

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

425 W Grand Ave
Suite 3002
Dayton, OH 45405-4722
Phone (937) 723-4231

Hospital & facility affiliations

  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue323
Removal of skin lesions31
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2164OHMDClinical Psychologist
36002164ROHMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dominic Dipierro, DPM, LLC Foot & Ankle Surgery Past Accepting new patients
Active Foot and Ankle Care LLC Foot & Ankle Surgery Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1699767269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1022",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454011022",
            "telephone_number": "937-221-8555",
            "fax_number": "937-567-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W GRAND AVE STE 3002",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054722",
            "telephone_number": "937-723-4231",
            "fax_number": "937-734-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGAN",
        "first_name": "MICHAEL",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36002164R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0530527",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE  PTAN NUMBER",
            "identifier": "4280581",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.