Organization Active NPI

Advanced Podiatry of Dearborn PC

  • Podiatrist
  • West Bloomfield, MI
National Provider Identifier
1891863726
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901000677 Issued in MI
Legal business name
ADVANCED PODIATRY OF DEARBORN PC
Practice address
7296 Simsbury Dr
West Bloomfield, MI 48322-3548
Phone
(248) 737-2343
Fax
(248) 737-3959
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Authorized official

Name
Dr. David Rosenberg, DPM
Title
President
Phone
(248) 737-2343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 5901000677 MI Primary

Addresses

Primary practice location

7296 Simsbury Dr
West Bloomfield, MI 48322-3548

Mailing address

7296 Simsbury Dr
West Bloomfield, MI 48322-3548
Phone (248) 737-2343

Other identifiers 2

IdentifierTypeStateIssuer
8825444OtherMIBLUE CROSS & BLUE SHIELD
1080580MedicaidMI

National Provider Directory

National Provider Directory

Locations

4515 Sylvia St
Inkster, MI 48141
Phone (313) 274-2383

36233 Willow Rd
New Boston, MI 48164
Phone (734) 654-4480

19640 Middlebelt Rd
Romulus, MI 48174
Phone (734) 783-2509

34932 Ecorse Rd
Romulus, MI 48174
Phone (248) 738-4986

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222387200000",
    "number": "1891863726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7296 SIMSBURY DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223548",
            "telephone_number": "248-737-2343",
            "fax_number": "248-737-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7296 SIMSBURY DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223548",
            "telephone_number": "248-737-2343",
            "fax_number": "248-737-3959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PODIATRY OF DEARBORN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2008-09-26",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-737-2343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901000677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "8825444",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1080580",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.