Individual provider Active NPI

Adina-Maria Anderson, DPM

  • Podiatrist
  • Iron Mountain, MI
National Provider Identifier
1730136672
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901002125 Issued in MI
Practice address
225 W H St
Iron Mountain, MI 49801-4608
Phone
(906) 776-5940
Fax
(906) 779-2586
NPI assigned
May 27, 2006
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5901002125 MI Primary

Addresses

Primary practice location

225 W H St
Iron Mountain, MI 49801-4608

Mailing address

PO Box 549
Iron Mountain, MI 49801-0549
Phone (906) 774-1313

Other identifiers 4

IdentifierTypeStateIssuer
5220021OtherMIBCBS OF MI
43241400MedicaidWI
4881074MedicaidMI
P00958672OtherMIRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

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
I20060802000170 MI Practitioner - Podiatry 1658384045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1721 S Stephenson Ave
Iron Mountain, MI 49801-3637
Phone (906) 774-1313

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue57
Removal of skin lesions1-10
Removal of nail tissue251
Removal or shaving of skin growth60

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Current Accepting new patients
Dickinson County Healthcare System CurrentSince May 1, 2011 Accepting new patients
Dickinson County Healthcare System CurrentSince May 1, 2011 Accepting new patients
Great Lakes Podiatry PLLC Past Accepting new patients
Great Lakes Podiatry PLLC Podiatrist PastSince Jan 1, 2005 Accepting new patients

Locations

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

225 W H St
Iron Mountain, MI 49801
Phone (906) 776-5930

Interoperability endpoints

  • Direct secure messaging: adina-maria.anderson.1@22710.direct.athenahealth.com
  • Direct secure messaging: adina-maria.anderson@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1730136672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498010549",
            "telephone_number": "906-774-1313",
            "fax_number": "906-776-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W H ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014608",
            "telephone_number": "906-776-5940",
            "fax_number": "906-779-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ADINA-MARIA",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901002125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "5220021",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43241400",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4881074",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00958672",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "225 W H St",
            "city": "Iron Mountain",
            "state": "MI",
            "country_code": "US",
            "postal_code": "498014608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.