Anthony Marc Mastrogiacomo, D.P.M

Primary specialty

PodiatristTaxonomy code 213E00000X

License

AM001831 Issued in MI

Practice address

22245 Pontiac TRL
South Lyon, MI 48178-1639

Phone

(248) 486-8886

Fax

(248) 486-8887

NPI assigned

Mar 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Lyon Foot and Ankle Specialists, P.C.Group PAC ID 6204808082, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Huron Valley-Sinai Hospital Hospital, Commerce Township, MI, CCN 230277

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amastrogiacomo1140463@direct.hfhs.org
• Direct secure messaging: amastrog@direct.dmc.org

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.

• South Lyon Foot & Ankle Specialists, P.C.

  • Podiatrist
  • South Lyon, MI
  • NPI 1003809682
  Medicare reassignment Care Compare group NPD
• Harvey Lefkowitz, D.P.M., P.C.

  • Podiatrist
  • Ferndale, MI
  • NPI 1316945413
  Medicare reassignment NPD

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

• VHS Huron Valley-Sinai Hospital Inc

  • General Acute Care Hospital
  • Commerce Township, MI
  • NPI 1922310200
  Care Compare affiliation

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1720055387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22245 PONTIAC TRL",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781639",
            "telephone_number": "248-486-8886",
            "fax_number": "248-486-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22245 PONTIAC TRL",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781639",
            "telephone_number": "248-486-8886",
            "fax_number": "248-486-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTROGIACOMO",
        "first_name": "ANTHONY",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "AM001831",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "AM001831",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4619433",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aparna Jagarlamudi Malempati
• George James Malik
• Robert Samuel Marvin
• Karen Laniece Massingille, LPC
• Madison Marie Masters, PA-C
• Michael Samir Matar, M.D
• Salima Sami Matariyeh, PHARMD
• Jacquelyn Margaret Mayowski, MS, LLPC
• Rebekah Marie McCormick, OTR/L
• Jill McGuire, R.D.

• Podiatrist in South Lyon, MI
• Providers in South Lyon, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; 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.