NPIMap

Organization Active NPI

Louis J Geller DPM PC

Doing business as Geller Foot Clinic

  • Podiatrist
  • Lathrup Village, MI
National Provider Identifier
1982714903
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901001926 Issued in MI
Legal business name
LOUIS J GELLER DPM PC
Doing business as
Geller Foot Clinic
Practice address
28460 Southfield Rd
Lathrup Village, MI 48076-2820
Phone
(248) 353-0096
Fax
(248) 809-6255
NPI assigned
Aug 30, 2006
Last updated
Jul 26, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Authorized official

Name
Louis Jeremy GellerNPI 1134100720
Title
Owner
Phone
(248) 353-0096

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5901001926 MI Primary
Podiatrist 213E00000X 0524 AZ

Addresses

Primary practice location

28460 Southfield Rd
Lathrup Village, MI 48076-2820

Mailing address

25841 Pembroke Rd
Huntington Woods, MI 48070-1621
Phone (248) 353-0096

Other identifiers 6

IdentifierTypeStateIssuer
4627620001OtherMIDMERC LICENSE NUMBER
2430677OtherMICIGNA
4431259MedicaidMI
101026OtherMIGREAT LAKES HEALTH PLAN
4856352050OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN
ON53230MedicaidMI

Other names 1

  • Geller Foot Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080528000096 MI Part B Supplier - Clinic/Group Practice 2264502665 Receives reassigned benefits from 6 practitioners
Practice locations: Lathrup Village, MI
O20100930011938 MI DME Supplier - Physician - Podiatry 2264502665 Practice locations: Lathrup Village, MI

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

28460 Southfield Rd
Lathrup Village, MI 48076
Phone (248) 353-0096

22401 Foster Winter Dr
Southfield, MI 48075
Phone (248) 423-4100

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564099200000",
    "number": "1982714903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25841 PEMBROKE RD",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701621",
            "telephone_number": "248-353-0096",
            "fax_number": "248-809-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28460 SOUTHFIELD RD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480762820",
            "telephone_number": "248-353-0096",
            "fax_number": "248-809-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUIS J GELLER DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-07-26",
        "status": "A",
        "authorized_official_last_name": "GELLER",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-353-0096"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001926",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "0524",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC LICENSE NUMBER",
            "identifier": "4627620001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2430677",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4431259",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HEALTH PLAN",
            "identifier": "101026",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "4856352050",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ON53230",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Geller Foot Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Geller Foot Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lathrup Village, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; 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.