East Side Foot & Ankle Clinic PC

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

Organization subpart

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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

• David H Berlin, DPM

  • Foot & Ankle Surgery Podiatrist
  • Troy, MI
  • NPI 1801803309
  Medicare reassignment NPD Authorized official

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2926711",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "89594B",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "480014028",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005335144",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS PIN",
            "identifier": "0Q24605",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Devan Dykstra
• Kenneth John Dziuba, M.D.
• Andrew I. Dzul, M.D.
• E&N Greater Mack Practices PLLC
• E&N Greater Mack Practices PLLC
• East Side Medical Services P C
• Eastlake Cardiovascular PC
• Eastside Associates, LLC
• Eastside Eye Physicians, PC
• Eastside Eye Physicians, PC

• Foot & Ankle Surgery Podiatrist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Foot & Ankle Surgery Podiatrist in Michigan

• 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.