Individual provider Active NPI

George Kardouss, DPM

  • Foot & Ankle Surgery Podiatrist
  • Dearborn, MI
National Provider Identifier
1780175687
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901400415 Issued in MI
Practice address
1213 Mason St
Dearborn, MI 48124-2841
Phone
(313) 561-2446
Fax
(313) 561-7299
NPI assigned
May 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901002723 MI
Foot & Ankle Surgery Podiatrist 213ES0103X 5901400415 MI Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 5951000847 MI

Addresses

Primary practice location

1213 Mason St
Dearborn, MI 48124-2841

Mailing address

1213 Mason St Ste 2
Dearborn, MI 48124-2841
Phone (248) 250-4738

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
I20220712003632 MI Practitioner - Podiatry 1951656446 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michigan Healthcare Professionals PCGroup PAC ID 0345413258, 525 clinicians
Associates in Family Practice PLLCGroup PAC ID 7416088463, 8 clinicians

Practice addresses (Care Compare)

1213 Mason St
Dearborn, MI 48124-2841
Phone (313) 278-2800

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

42755 Mound Rd
Sterling Heights, MI 48314-3255
Phone (586) 323-0400

Hospital & facility affiliations

  • Holistic Home Healthcare, LLC Home health agency, Garden City, MI, CCN 239333
  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Corewell Health Wayne Hospital Hospital, Wayne, MI, CCN 230142

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions13
Removal of nail tissue149
Removal or shaving of skin growth60

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5901400415MIMDFoot & Ankle Surgery Podiatrist
5951000847MIMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Jul 1, 2023 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Jul 1, 2023 Accepting new patients
Associates in Family Practice PLLC CurrentSince Jul 15, 2023 Accepting new patients

Locations

8025 Allen Rd
Allen Park, MI 48101
Phone (313) 386-0080

245 E Warwick Dr
Ste C
Alma, MI 48801
Phone (989) 463-2150

1213 Mason St
Ste 2
Dearborn, MI 48124

1213 Mason St
Dearborn, MI 48124
Phone (313) 278-2800

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

1621 E Broomfield St
Mt Pleasant, MI 48858
Phone (989) 317-4153

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

29201 Telegraph Rd
Ste 450
Southfield, MI 48034
Phone (248) 304-7659

42755 Mound Rd
Sterling Hts, MI 48314
Phone (586) 323-0400

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1780175687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 MASON ST STE 2",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242841",
            "telephone_number": "248-250-4738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 MASON ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242841",
            "telephone_number": "313-561-2446",
            "fax_number": "313-561-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARDOUSS",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-25",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901002723",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901400415",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5951000847",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.