Individual provider Active NPI

Michael Andrew Dekorte, DPM

  • Podiatrist
  • Medford, OR
National Provider Identifier
1982795050
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DP00247 Issued in OR
Practice address
713 Golf View Drive
Medford, OR 97504-9643
Phone
(541) 770-1225
Fax
(541) 770-1245
NPI assigned
Sep 27, 2006
Last updated
Jan 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DP00247 OR Primary
Foot Surgery Podiatrist 213ES0131X DP00247 OR

Addresses

Primary practice location

713 Golf View Drive
Medford, OR 97504-9643

Mailing address

713 Golf View Drive
Medford, OR 97504-9643
Phone (541) 770-1225

Other identifiers 3

IdentifierTypeStateIssuer
1297890041OtherORCIGNA (DMERC)
480029243OtherORRAILROAD MEDICARE
056981MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101029000209 OR Practitioner - Podiatry 6305835463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medford Foot and Ankle Clinic, PCGroup PAC ID 4082603121, 4 clinicians

Practice addresses (Care Compare)

713 Golf View Dr
Medford, OR 97504-9643
Phone (541) 770-1225

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue35
Removal of skin lesions87
Removal of nail tissue1107
Removal or shaving of skin growth69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DP00247ORMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medford Foot & Ankle Clinic, PC Podiatrist CurrentSince Jan 1, 2000 Accepting new patients

Locations

713 Golf View Dr
Medford, OR 97504
Phone (541) 770-1225

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: michaeldekorte@mfaacp-or.direct.office.nextgen.com

Organizations & group practices 1

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 1

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1982795050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 GOLF VIEW DRIVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049643",
            "telephone_number": "541-770-1225",
            "fax_number": "541-770-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 GOLF VIEW DRIVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049643",
            "telephone_number": "541-770-1225",
            "fax_number": "541-770-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEKORTE",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP00247",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "OR",
            "license": "DP00247",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA (DMERC)",
            "identifier": "1297890041",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480029243",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056981",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.