SOUTHEAST MICHIGAN SURGICAL HOSPITAL
NPI 1295865392
Podiatrist in Warren, MI
NPI Status: Active since March 07, 2007
Contact Information
21230 DEQUINDRE RD
WARREN, MI
ZIP 48091
Phone: (586) 427-1000
Fax: (586) 759-0237
- Organization
- Podiatrist
- Accepts Insurance
- CLIA Number: 23D1022232
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 07-02-2027
About SOUTHEAST MICHIGAN SURGICAL HOSPITAL
This page provides the complete NPI Profile along with additional information for Southeast Michigan Surgical Hospital, a provider established in Warren, Michigan operating as a Podiatrist. The healthcare provider is registered in the NPI registry with number 1295865392 assigned on March 2007. The practitioner's primary taxonomy code is 213E00000X with license number 500100 (MI). The provider is registered as an organization and their NPI record was last updated 13 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Southeast Michigan Surgical Hospital. The authorized official of this NPI record is Mr. Jeffrey A Poulsen (Cfo)
- NPI
- 1295865392
- Provider Legal Name
- SOUTHEAST MICHIGAN SURGICAL HOSPITAL, LLC
- Other Organization Name
- SOUTHEAST MICHIGAN SURGICAL HOSPITAL
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 21230 DEQUINDRE RD WARREN, MI 48091
- Location Phone
- (586) 427-1000
- Location Fax
- (586) 759-0237
- Mailing Address
- 21230 DEQUINDRE RD WARREN, MI 48091
- Mailing Phone
- (586) 427-1000
- Mailing Fax
- (586) 759-0237
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-07-2007
- Last Update Date
- 04-12-2013
- Code Navigator
A podiatrist like Southeast Michigan Surgical Hospital provides medical and surgical care for people with foot, ankle, and lower leg issues. Podiatrists treat foot and ankle ailments like calluses, ingrown toenails, heel spurs, arthritis, congenital foot deformities, foot problems associated with diabetes and arch problems.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Podiatrist
- Taxonomy Code
- 213E00000X
- Type
- Podiatric Medicine & Surgery Service Providers
- License No.
- 500100
- License State
- MI
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist |
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Preferred HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Value - HMO
- Blue Cross� Select HMO Bronze Extra - HMO
- Blue Cross� Select HMO Bronze Saver HSA - HMO
- Blue Cross� Select HMO Bronze Secure - HMO
- Blue Cross� Select HMO Silver - HMO
- Blue Cross� Select HMO Silver Extra - HMO
- Blue Cross� Select HMO Silver Saver - HMO
- Blue Cross� Select HMO Value - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze Saver HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2619390 | MEDICAID (05) | MI | |
| 0E00146 | OTHER (01) | MI | PODIATRIST GROUP ID # |
| 0N79800 | MEDICARE ID-TYPE UNSPECIFIED (04) | MI | PODIATRIST |
| 0E01458 | OTHER (01) | MI | BCBS PROVIDER ID # |
| ON79780 | MEDICARE UPIN (02) |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D1022232
- Facility Type
- Hospital
- Certificate Effective Date
- July 03, 2025
- Certificate Expiration Date
- July 02, 2027
- Laboratory Director
- MOHAMED ELFAKHARANY
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Southeast Michigan Surgical Hospital on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
Reviews for SOUTHEAST MICHIGAN SURGICAL HOSPITAL
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1295865392, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 68 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
WARREN, MI 48091
WARREN, MI 48091
WARREN, MI 48091
WARREN, MI 48091
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1295865392, enumerated as an "organization" on March 07, 2007.
The provider is located at 21230 DEQUINDRE RD WARREN, MI 48091 and the phone number is (586) 427-1000.
Podiatrist with taxonomy code 213E00000X.
The provider might be accepting Accepts: Blue Care Network of Michigan, Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.
