Provider Demographics
NPI:1922242726
Name:BC PODIATRY PLLC
Entity Type:Organization
Organization Name:BC PODIATRY PLLC
Other - Org Name:GENTLE FOOT & ANKLE CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:BURKARDT
Authorized Official - Last Name:DPM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-308-2973
Mailing Address - Street 1:31017 JOHN R RD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-1907
Mailing Address - Country:US
Mailing Address - Phone:248-585-1177
Mailing Address - Fax:248-585-0083
Practice Address - Street 1:8391 COMMERCE RD STE 102
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-4489
Practice Address - Country:US
Practice Address - Phone:248-363-3777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI480F337000OtherBLUE CROSS FEP
MI480F337000OtherBLUE CROSS
MICN3339OtherRAILROAD MEDICARE
6242670001OtherMEDICARE DMEPOS
MI0P41010OtherMEDICARE PLUS BLUE
MI5223312Medicaid
MI0P41010OtherMEDICARE ADVANTAGE
480F394220OtherBLUE CROSS BLUE SHIELD
MI0P41010OtherMEDICARE PLUS BLUE