MEDICARE: LOOKING GLASS FOOT & ANKLE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	5901002235	MI

General Provider Information

NPI Number	:	1801116652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOOKING GLASS FOOT & ANKLE PC

Provider Business Mailing Address
First Line	:	13765 S SEDONA PKWY
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48906-8103
Country	:	US
Telephone Number	:	517-668-6166
Fax Number	:	517-668-6169

Provider Business Practice Location Address
First Line	:	13765 S SEDONA PKWY
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48906-8103
Country	:	US
Telephone Number	:	517-668-6166
Fax Number	:	517-668-6169

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANDREA KAY SIMONS
Credential	:	DPM
Telephone Number	:	517-668-6166

Provider Enumeration Date	:	06/03/2010
Last Update Date	:	05/20/2026

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