Rene Siazon Juridico, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

5901400406 Issued in MI

Practice address

1600 S Kalamazoo Ave Ste a
Marshall, MI 49068-8730

Phone

(269) 781-4700

Fax

(269) 781-7168

NPI assigned

Aug 3, 2018

Last updated

Mar 1, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spartan Podiatry PCGroup PAC ID 4789816117, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Oaklawn Hospital Hospital, Marshall, MI, CCN 230217

Merit-based Incentive Payment System (MIPS)

Final score

84.63 of 100Reported as individual

Quality

65.35

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rene.juridico.1@20440.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/20440/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spartan Podiatry PC

  • Primary Podiatric Medicine Podiatrist
  • Marshall, MI
  • NPI 1467664904
  Medicare reassignment Care Compare group NPD

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

• Ella E. M. Brown Charitable Circle

  dba Oaklawn Hospital

  • General Acute Care Hospital
  • Marshall, MI
  • NPI 1861475360
  Care Compare affiliation

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1720566466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 WATERTOWER PL STE 300",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238049",
            "telephone_number": "517-351-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S KALAMAZOO AVE STE A",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490688730",
            "telephone_number": "269-781-4700",
            "fax_number": "269-781-7168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURIDICO",
        "first_name": "RENE",
        "middle_name": "SIAZON",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-03",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901400406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aime Johnston, COTA
• Joseph M Hibler OD PC Inc
• Shobhana Sharad Joshi, MD
• Kerri Jule, LMSW
• Alicia Deborah Ann Julovich, MD
• Aparna Kanaparthi
• Suzanne Kape
• Lina Keeney-Fuhr
• Kevin Andrew Kelch, PA
• Bradley Kelly, LLPC

• Foot & Ankle Surgery Podiatrist in Marshall, MI
• Providers in Marshall, MI by specialty
• Foot & Ankle Surgery Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.