Thomas Daniel Paholak, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

5901001714 Issued in MI

Practice address

12786 Lasalle LN
Huntington Woods, MI 48070-1020

Phone

(248) 572-3900

Fax

(248) 572-1277

NPI assigned

May 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IL, MI2 enrollments

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 2

Specialty

Podiatry

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Podiatry Services LTDGroup PAC ID 8820007180, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.5 of 100Reported as group

Quality

75

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: premierpodiatryservices.thomaspaholak@134368.advancedmd-direct.com

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.

• Premier Podiatry Services, LTD

  • Podiatrist
  • Lincolnwood, IL
  • NPI 1528250669

  MI

  Medicare reassignment Care Compare group NPD Authorized official
• Mobile Podiatry Services, PC

  • Foot Surgery Podiatrist
  • Huntington Woods, MI
  • NPI 1720442056
  NPD (past) Authorized official

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1710934955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6374 N LINCOLN AVE STE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591283",
            "telephone_number": "773-866-9800",
            "fax_number": "773-866-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12786 LASALLE LN",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701020",
            "telephone_number": "248-572-3900",
            "fax_number": "248-572-1277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6374 N Lincoln Ave Ste 303",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606591283",
            "country_code": "US",
            "telephone_number": "773-866-9800",
            "fax_number": "773-866-1733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAHOLAK",
        "first_name": "THOMAS",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016004340",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "IL",
            "license": "016-004340",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL STATE LICENSE",
            "identifier": "016-004340",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001623503",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016-004340",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480027688",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Occupational Therapy Solutions PLLC
• Leandra Marie Osborn, LMT
• Karen Lenane Ostrowski, NP
• P. Adler, PC
• Nirupama P Padiyar, MD
• Palm Family Dental DDS PC
• William M Palm, D.D.S.
• Pamela Warner Marsh Psy D PLLC
• Pamela Warner Marsh, Psy.D., PLLC
• Harrison S C Parker, LLMSW

• Podiatrist in Huntington Woods, MI
• Providers in Huntington Woods, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.