Organization Active NPI

East Side Foot & Ankle Clinic PC

  • Foot & Ankle Surgery Podiatrist
  • Saint Clair Shores, MI
National Provider Identifier
1801910229
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901001005 Issued in MI
Legal business name
EAST SIDE FOOT & ANKLE CLINIC PC
Practice address
22301 Greater Mack Ave
Suite 3
Saint Clair Shores, MI 48080-2376
Phone
(586) 776-7000
Fax
(586) 776-7003
NPI assigned
Mar 19, 2007
Last updated
Sep 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Authorized official

Name
Dr. David Berlin, D.P.M.NPI 1801803309
Title
Owner
Phone
(586) 776-7000

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 5901001005 MI Primary
Customized Equipment (DME) 332BC3200X 5901001005 MI

Addresses

Primary practice location

22301 Greater Mack Ave
Suite 3
Saint Clair Shores, MI 48080-2376

Mailing address

22301 Greater Mack Ave
Suite 3
Saint Clair Shores, MI 48080-2376
Phone (586) 776-7000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110714000325 MI Part B Supplier - Clinic/Group Practice 3971614421 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Clair Shores, MI

National Provider Directory

National Provider Directory

Locations

19570 Kelly Rd
Harper Woods, MI 48225
Phone (313) 371-5300

22301 Greater Mack Ave
Ste 3
St Clr Shores, MI 48080
Phone (313) 371-5300

Practitioners & affiliated clinicians

Practitioners 1

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": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759190400000",
    "number": "1801910229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22301 GREATER MACK AVE",
            "address_2": "SUITE 3",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802376",
            "telephone_number": "586-776-7000",
            "fax_number": "586-776-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22301 GREATER MACK AVE",
            "address_2": "SUITE 3",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802376",
            "telephone_number": "586-776-7000",
            "fax_number": "586-776-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SIDE FOOT & ANKLE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A",
        "authorized_official_last_name": "BERLIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-776-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901001005",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "MI",
            "license": "5901001005",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.