NPIMap

Individual provider Active NPI

Samuel Thaddeus Austin, DPM

  • Podiatrist
  • Dearborn, MI
National Provider Identifier
1891222964
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901400369 Issued in MI
Practice address
22720 Michigan Ave Ste 175
Dearborn, MI 48124-2000
Phone
(248) 717-0000
Fax
(248) 617-0006
NPI assigned
May 18, 2017
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 5901400369 MI Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901400369 MI

Addresses

Primary practice location

22720 Michigan Ave Ste 175
Dearborn, MI 48124-2000

Mailing address

22720 Michigan Ave Ste 175
Dearborn, MI 48124-2000
Phone (248) 717-0000

Other practice location 1

555 Barclay Cir Ste 100
Rochester Hills, MI 48307-4574
Phone (248) 717-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200630002346 MI Practitioner - Podiatry 9638592132 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epic Foot and Ankle PLLCGroup PAC ID 8123473477, 4 clinicians

Practice addresses (Care Compare)

22720 Michigan Ave
Suite 175
Dearborn, MI 48124-2000
Phone (917) 498-1769

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue210
Removal of skin lesions71
Removal of nail tissue257
Removal or shaving of skin growth53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Foot & Ankle PLLC Single Specialty CurrentSince Sep 9, 2024 Accepting new patients
Epic Foot & Ankle Specialists PLLC Podiatrist CurrentSince Feb 11, 2026 Accepting new patients
Ma Foot & Ankle PLLC Single Specialty PastSince Jun 11, 2023 Accepting new patients

Locations

720 Livingston St
Ste 1
Bay City, MI 48708
Phone (989) 895-8594

22720 Michigan Ave
Ste 175
Dearborn, MI 48124
Phone (248) 717-0000

555 Barclay Cir
Ste 100
Rochester Hills, MI 48307
Phone (248) 717-0000

Interoperability endpoints

  • Direct secure messaging: saustin3999683@direct.trinity-health.org
  • Direct secure messaging: saustin1115666@direct.hfhs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1891222964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22720 MICHIGAN AVE STE 175",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242000",
            "telephone_number": "248-717-0000",
            "fax_number": "248-617-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22720 MICHIGAN AVE STE 175",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242000",
            "telephone_number": "248-717-0000",
            "fax_number": "248-617-0006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Barclay Cir Ste 100",
            "address_purpose": "LOCATION",
            "city": "Rochester Hills",
            "state": "MI",
            "postal_code": "483074574",
            "country_code": "US",
            "telephone_number": "248-717-0000",
            "fax_number": "248-617-0006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUSTIN",
        "first_name": "SAMUEL",
        "middle_name": "THADDEUS",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-18",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901400369",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901400369",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.