Individual provider Active NPI

Dennis Eder, DPM

  • Podiatrist
  • Farmington Hills, MI
National Provider Identifier
1740203785
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DE000786 Issued in MI
Practice address
30335 W 13 Mile Rd Ste 100
Farmington Hills, MI 48334
Phone
(248) 476-1616
Fax
(248) 476-6683
NPI assigned
Jul 25, 2006
Last updated
May 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DE000786 MI Primary

Addresses

Primary practice location

30335 W 13 Mile Rd Ste 100
Farmington Hills, MI 48334

Mailing address

24300 Orchard Lake Rd
Farmington Hills, MI 48336
Phone (248) 476-1616

Other identifiers 2

IdentifierTypeStateIssuer
480009796OtherMIMEDICARE RR PIN
1275535MedicaidMI

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
I20101008000587 MI Practitioner - Podiatry 2466495544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30335 W 13 Mile Rd
Suite 100
Farmington Hills, MI 48334-2262
Phone (248) 476-1616

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE000786MIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth R Lawrence DPM PC Podiatrist CurrentSince Mar 1, 1979 Accepting new patients

Locations

30335 W 13 Mile Rd
Ste 100
Farmington Hills, MI 48334
Phone (248) 476-1616

Organizations & group practices 1

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 1

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1740203785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24300 ORCHARD LAKE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48336",
            "telephone_number": "248-476-1616",
            "fax_number": "248-476-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30335 W 13 MILE RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48334",
            "telephone_number": "248-476-1616",
            "fax_number": "248-476-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDER",
        "first_name": "DENNIS",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "DE000786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR PIN",
            "identifier": "480009796",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275535",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.