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SOUTH LYON FOOT & ANKLE SPECIALISTS, P.C.
NPI 1003809682
Podiatrist in South Lyon, MI

Active since August 29, 2005CLIA 23D1033020 · Waiver
22245 PONTIAC TRL, SOUTH LYON, MI 48178(248) 486-8886(248) 486-8887 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1003809682
Entity TypeOrganization
Primary Taxonomy213E00000X
Legal Business NameSOUTH LYON FOOT & ANKLE SPECIALISTS, P.C.
Location Address22245 PONTIAC TRLSouth Lyon, MI 48178-1639
Mailing Address22245 Pontiac TrlSouth Lyon, MI 48178-1639 · (248) 486-8886 · Fax (248) 486-8887
Phone(248) 486-8886
Fax(248) 486-8887
Organization SubpartNo
Authorized OfficialAnthony MastrogiocomoOwner/president/podiatrist · (248) 486-8886
Enumeration DateAugust 29, 2005
Last NPPES UpdateJuly 21, 2022
✔ NPI 1003809682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
22245 PONTIAC TRL, South Lyon, MI 48178
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Other Identifiers 1

Other4856311830MI · Bcbs

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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, MI
Active · expires Nov 2, 2026
CLIA Number23D1033020
Laboratory TypePhysician Office
Certificate Effective DateNovember 3, 2024
Certificate Expiration DateNovember 2, 2026
Laboratory DirectorAnthony Mastrogiacomo
Laboratory Phone(248) 486-8886
Laboratory LocationSouth Lyon Foot & Ankle Specialists22245 Pontiac Trail, South Lyon, MI 48178
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANTHONY MARC MASTROGIACOMO D.P.M
Podiatrist
22245 PONTIAC TRL
SOUTH LYON, MI 48178
Oakland County (248) 486-8886

Frequently 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.

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 Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and 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.