SOUTH LYON FOOT & ANKLE SPECIALISTS, P.C.
NPI 1003809682
Podiatrist in South Lyon, MI
About South Lyon Foot & Ankle Specialists, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH LYON FOOT & ANKLE SPECIALISTS, P.C. (NPI 1003809682) is a healthcare organization registered as a podiatrist in South Lyon, Michigan and active in the NPI registry since August 2005. The organization holds a CLIA Waiver certificate valid through November 2, 2026 and lists Anthony Mastrogiocomo, Owner/president/podiatrist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
South Lyon Foot & Ankle Specialists, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to South Lyon Foot & Ankle Specialists, P.C., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 23D1033020
South Lyon Foot & Ankle Specialists · South Lyon, MIFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is South Lyon Foot & Ankle Specialists, P.C.'s NPI number?
The NPI number for South Lyon Foot & Ankle Specialists, P.C. is 1003809682. It was assigned to this organization in the NPPES registry on August 29, 2005.
Where is South Lyon Foot & Ankle Specialists, P.C. located?
South Lyon Foot & Ankle Specialists, P.C. is located at 22245 Pontiac Trl, South Lyon, MI 48178. The listed phone number is (248) 486-8886.
What is South Lyon Foot & Ankle Specialists, P.C.'s specialty?
The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.
Is South Lyon Foot & Ankle Specialists, P.C. enrolled in Medicare?
Yes. South Lyon Foot & Ankle Specialists, P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through South Lyon Foot & Ankle Specialists, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Podiatry, reassign their Medicare billing to South Lyon Foot & Ankle Specialists, P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does South Lyon Foot & Ankle Specialists, P.C. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 23D1033020) is associated with this NPI, valid through November 2, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does South Lyon Foot & Ankle Specialists, P.C. accept?
Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list South Lyon Foot & Ankle Specialists, P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for South Lyon Foot & Ankle Specialists, P.C. was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# South Lyon Foot & Ankle Specialists, P.c. · NPI 1003809682
Podiatrist organization in South Lyon, Michigan. Organization record, active in the CMS NPPES registry since August 29, 2005.
## Identity
- **NPI:** 1003809682 (Entity type: Organization)
- **Enumerated:** August 29, 2005
- **Primary specialty:** Podiatrist · taxonomy 213E00000X
- **Organization subpart:** No
- **Authorized official:** Anthony Mastrogiocomo, OWNER/PRESIDENT/PODIATRIST
## Practice location
- **Address:** 22245 PONTIAC TRL, South Lyon, MI 48178-1639
- **Phone:** (248) 486-8886 · **Fax:** (248) 486-8887
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Podiatry) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 21, 2022
- **Other identifiers:** Other 4856311830 (MI)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1003809682) · Data from the CMS NPPES public registry.