Organization Active NPI

Steven R Migdalewicz DPM PC

  • Podiatrist
  • Novi, MI
National Provider Identifier
1972635829
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901001589 Issued in MI
Legal business name
STEVEN R MIGDALEWICZ DPM PC
Practice address
30750 Tanglewood Dr
Novi, MI 48377-1589
Phone
(248) 624-5835
Fax
(248) 624-7961
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Authorized official

Name
Dr. Steven R Migdalewicz, DPMNPI 1902890627
Title
Owner
Phone
(248) 624-5835

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 5901001589 MI Primary

Addresses

Primary practice location

30750 Tanglewood Dr
Novi, MI 48377-1589

Mailing address

30750 Tanglewood Dr
Novi, MI 48377-1589
Phone (248) 624-5835

Other identifiers 4

IdentifierTypeStateIssuer
480F365460OtherMIBCBSM
4856354340OtherMIBCBS PROVIDER ID
480034036OtherMIRAILROAD PROVIDER ID
134375070MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070319000284 MI Part B Supplier - Clinic/Group Practice 8426151119 Receives reassigned benefits from 1 practitioner
Practice locations: Novi, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1972635829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30750 TANGLEWOOD DR",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483771589",
            "telephone_number": "248-624-5835",
            "fax_number": "248-624-7961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30750 TANGLEWOOD DR",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483771589",
            "telephone_number": "248-624-5835",
            "fax_number": "248-624-7961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN R MIGDALEWICZ DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "MIGDALEWICZ",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-624-5835",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "480F365460",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "4856354340",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PROVIDER ID",
            "identifier": "480034036",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134375070",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.