Individual provider Active NPI

Anthony J. Bianchi, DPM

  • Podiatrist
  • Fort Gratiot, MI
National Provider Identifier
1861401994
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901001442 Issued in MI
Practice address
3566 Connie LN
Fort Gratiot, MI 48059-4103
Phone
(810) 824-1376
Fax
(810) 294-5049
NPI assigned
Aug 7, 2006
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5901001442 MI Primary
Foot Surgery Podiatrist 213ES0131X 5901001442 MI

Addresses

Primary practice location

3566 Connie LN
Fort Gratiot, MI 48059-4103

Mailing address

3566 Connie LN
Fort Gratiot, MI 48059-4103
Phone (810) 824-1376

Other identifiers 1

IdentifierTypeStateIssuer
2886017MedicaidMI

Other names 1

  • Anthony J White Former name

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
I20120516000703 MI Practitioner - Podiatry 0143423574 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1988
Medicare assignment
May accept Medicare assignment
Group practices
Healthdrive Podiatry Group PCGroup PAC ID 3375446958, 105 clinicians

Practice addresses (Care Compare)

120 N Washington SQ Ofc
378 Healthdrive Podiatry Group
Lansing, MI 48933-1617
Phone (888) 964-6681

1209 10TH St B
Port Huron, MI 48060-5296

3566 Connie LN
Fort Gratiot, MI 48059-4103
Phone (810) 824-1376

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1838
Removal or shaving of skin growth58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5901001442MIMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony J. Bianchi DPM P.C. Foot Surgery CurrentSince Jul 17, 2006 Accepting new patients
Healthdrive Podiatry Group, PC Podiatrist CurrentSince Aug 8, 2022 Accepting new patients

Locations

1209 10th St
Ste B
Port Huron, MI 48060
Phone (810) 985-3346

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1861401994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3566 CONNIE LN",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594103",
            "telephone_number": "810-824-1376",
            "fax_number": "810-294-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3566 CONNIE LN",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594103",
            "telephone_number": "810-824-1376",
            "fax_number": "810-294-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIANCHI",
        "first_name": "ANTHONY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001442",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MI",
            "license": "5901001442",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2886017",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTHONY",
            "last_name": "WHITE",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Gratiot, MI

Sources for this page

Verify at the official NPI Registry.