Individual provider Active NPI

Bhavik Patel, DPM

  • Foot & Ankle Surgery Podiatrist
  • Saint Clair Shores, MI
National Provider Identifier
1790300978
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5951001392 Issued in MI
Practice address
24025 Greater Mack Ave Ste 101
Saint Clair Shores, MI 48080-4311
Phone
(313) 513-8071
NPI assigned
Jun 12, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5951001392 MI Primary

Addresses

Primary practice location

24025 Greater Mack Ave Ste 101
Saint Clair Shores, MI 48080-4311

Mailing address

24025 Greater Mack Ave Ste 101
Saint Clair Shores, MI 48080-4311
Phone (313) 513-8071

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
I20230615000874 MI Practitioner - Podiatry 2264854967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastside Podiatry PLLCGroup PAC ID 5395724009, 3 clinicians

Practice addresses (Care Compare)

24025 Greater Mack Ave
Suite 101
Saint Clair Shores, MI 48080-4311
Phone (313) 884-7566

Hospital & facility affiliations

  • Affinity Home Care, LLC Home health agency, Saint Clair Shores, MI, CCN 237502
  • Alpha Therapeutics, PC Home health agency, Warren, MI, CCN 237721
  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • Ascension St John Hospital Inpatient rehabilitation facility, Detroit, MI, CCN 23T165

Merit-based Incentive Payment System (MIPS)

Final score
53.82 of 100Reported as group
Quality
89.89
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue247
Removal of skin lesions83
Removal of nail tissue720
Removal or shaving of skin growth461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eastside Podiatry PLLC Foot & Ankle Surgery CurrentSince Jul 1, 2023 Accepting new patients

Locations

24025 Greater Mack Ave
Ste 101
St Clr Shores, MI 48080
Phone (313) 884-7566

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1790300978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24025 GREATER MACK AVE STE 101",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480804311",
            "telephone_number": "313-513-8071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24025 GREATER MACK AVE STE 101",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480804311",
            "telephone_number": "313-513-8071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "BHAVIK",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-12",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5951001392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.