NPIMap

Organization Active NPI

Premier Foot & Ankle PLLC

  • Foot & Ankle Surgery Podiatrist
  • West Bloomfield, MI
National Provider Identifier
1801361365
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
PREMIER FOOT & ANKLE PLLC
Practice address
5777 W Maple Rd Ste 170
West Bloomfield, MI 48322-4448
Phone
(586) 948-9417
Fax
(586) 846-3910
NPI assigned
Oct 10, 2018
Last updated
Aug 2, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PREMIER FOOT & ANKLE PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Authorized official

Name
Stefano Matthew Militello, DPMNPI 1154558245
Title
Owner
Phone
(586) 948-9417

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 Primary

Addresses

Primary practice location

5777 W Maple Rd Ste 170
West Bloomfield, MI 48322-4448

Mailing address

17900 23 Mile Rd Ste 204
Macomb, MI 48044-1161
Phone (586) 948-9417

National Provider Directory

National Provider Directory
Part of
Premier Foot Ankle PLLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

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": "1539129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659398400000",
    "number": "1801361365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17900 23 MILE RD STE 204",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480441161",
            "telephone_number": "586-948-9417",
            "fax_number": "586-846-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 W MAPLE RD STE 170",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224448",
            "telephone_number": "586-948-9417",
            "fax_number": "586-846-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER FOOT & ANKLE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER FOOT & ANKLE PLLC",
        "enumeration_date": "2018-10-10",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A",
        "authorized_official_last_name": "MILITELLO",
        "authorized_official_first_name": "STEFANO",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-948-9417",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.