Organization Active NPI

Ankle & Foot Clinic PC

Doing business as None

  • Foot & Ankle Surgery Podiatrist
  • Eastpointe, MI
National Provider Identifier
1770511784
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901001883 Issued in MI
Legal business name
ANKLE & FOOT CLINIC PC
Doing business as
None
Practice address
23700 Gratiot Ave
Eastpointe, MI 48021-1647
Phone
(586) 779-1160
Fax
(586) 779-1163
NPI assigned
Jun 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Syed M Ghani, DPMNPI 1174521439
Title
President
Phone
(586) 779-1160

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901001883 MI Primary

Addresses

Primary practice location

23700 Gratiot Ave
Eastpointe, MI 48021-1647

Mailing address

23700 Gratiot Ave
Eastpointe, MI 48021-1647
Phone (586) 779-1160

Other names 1

  • NONE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041026001129 MI Part B Supplier - Clinic/Group Practice 3375504954 Receives reassigned benefits from 1 practitioner
Practice locations: Eastpointe, MI
O20100930047411 MI DME Supplier - Physician - Podiatry 3375504954 Practice locations: Eastpointe, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770511784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23700 GRATIOT AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480211647",
            "telephone_number": "586-779-1160",
            "fax_number": "586-779-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23700 GRATIOT AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480211647",
            "telephone_number": "586-779-1160",
            "fax_number": "586-779-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANKLE & FOOT CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GHANI",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-779-1160",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901001883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NONE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eastpointe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.