Saginaw Valley Foot & Ankle Center

Primary specialty

PodiatristTaxonomy code 213E00000X

License

DT001450 Issued in MI

Legal business name

SAGINAW VALLEY FOOT & ANKLE CENTER

Practice address

5400 Mackinaw
Suite 2100
Saginaw, MI 48604-9549

Phone

(989) 790-4662

Fax

(989) 790-7680

NPI assigned

Dec 29, 2007

Last updated

May 15, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Derek Robert Tesoro, DPMNPI 1891873022

Title

Owner Physician

Phone

(989) 790-4662

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

Locations

Practitioners 2

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.

• Derek Robert Tesoro, DPM

  • Podiatrist
  • Saginaw, MI
  • NPI 1891873022
  Medicare reassignment Care Compare group NPD Authorized official
• Taylor Lilamia Tesoro-Fila, DPM

  • Podiatrist
  • Saginaw, MI
  • NPI 1134789340
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1198886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1871778647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 MACKINAW",
            "address_2": "SUITE 2100",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486049549",
            "telephone_number": "989-790-4662",
            "fax_number": "989-790-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 MACKINAW",
            "address_2": "SUITE 2100",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486049549",
            "telephone_number": "989-790-4662",
            "fax_number": "989-790-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGINAW VALLEY FOOT & ANKLE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-29",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "TESORO",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "989-790-4662",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "DT001450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3173006",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4857311150",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "480019411",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SUPPLIER ID",
            "identifier": "1198630001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11290415",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Saginaw Valley Centers, Inc. (DOT Caring Centers, Inc.)
• Saginaw Valley Dermatology PC
• Saginaw Valley Endoscopy Center
• Saginaw Valley Family Care, PLLC (Saginaw Valley Family Care)
• Saginaw Valley Family Medicine, PC
• Saginaw Valley Geriatrics PLLC
• Saginaw Valley Hearing Clinic
• Saginaw Valley Medical Care PLC
• Saginaw Valley Medical Center PLLC
• Saginaw Valley Medical Imaging

• Podiatrist in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.