Organization Active NPI

Jeffrey Schwalb DPM PLLC

  • Foot & Ankle Surgery Podiatrist
  • W Bloomfield, MI
National Provider Identifier
1780182907
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
JS001177 Issued in MI
Legal business name
JEFFREY SCHWALB DPM PLLC
Practice address
5755 W Maple Rd Ste 115
W Bloomfield, MI 48322-4415
Phone
(248) 626-7180
NPI assigned
Jan 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Authorized official

Name
Jeffrey Schwalb, DPMNPI 1962410589
Title
Owner
Phone
(248) 626-7180

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 PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X JS001177 MI Primary

Addresses

Primary practice location

5755 W Maple Rd Ste 115
W Bloomfield, MI 48322-4415

Mailing address

5755 W Maple Rd Ste 115
W Bloomfield, MI 48322-4415
Phone (248) 626-7180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180306001744 MI Part B Supplier - Clinic/Group Practice 4789945841 Receives reassigned benefits from 3 practitioners
Practice locations: Warren, MI; West Bloomfield, MI

National Provider Directory

National Provider Directory

Locations

21647 Ryan Rd
Ste 1
Warren, MI 48091

5755 W Maple Rd
Ste 115
West Bloomfield, MI 48322
Phone (248) 626-7180

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516665600000",
    "number": "1780182907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5755 W MAPLE RD STE 115",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224415",
            "telephone_number": "248-626-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 W MAPLE RD STE 115",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224415",
            "telephone_number": "248-626-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY SCHWALB DPM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-01-23",
        "status": "A",
        "authorized_official_last_name": "SCHWALB",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-626-7180",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "JS001177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in W Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; 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.