NPIMap

Individual provider Active NPI

Surinder Mendiratta, MD

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1003847617
Registry record updated May 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301060904 Issued in MI
Practice address
20905 Greenfield Rd
Suite 502
Southfield, MI 48075-5360
Phone
(248) 395-2888
Fax
(248) 395-2891
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301060904 MI Primary

Addresses

Primary practice location

20905 Greenfield Rd
Suite 502
Southfield, MI 48075-5360

Mailing address

20905 Greenfield Rd
Suite 502
Southfield, MI 48075-5360
Phone (248) 395-2888

Other identifiers 1

IdentifierTypeStateIssuer
4299782MedicaidMI

Other names 1

  • Surinder Mendiratta Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080315000036 MI Practitioner - Internal Medicine 1254416241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3000

20905 Greenfield Rd
Suite 205
Southfield, MI 48075-5346
Phone (248) 395-2888

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301060904MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surinder Mendiratta PLLC Internal Medicine CurrentSince Jun 1, 2001 Accepting new patients
Oakpointe Senior Care and Rehab Center, LLC Past Accepting new patients
West Oaks Senior Care and Rehab Center, LLC Past Accepting new patients
Henry Ford Health Providence Hospital Past Accepting new patients
VHS Sinai-Grace Hospital Inc Past Accepting new patients
Redford Opco, LLC Past Accepting new patients
Chelsea Health Center, LLC Past Accepting new patients
Fairlane Senior Care and Rehab Center, LLC Past Accepting new patients
Select Specialty - Downriver LLC Past Accepting new patients
Chaplains, Inc. Past Accepting new patients

Locations

6071 W Outer Dr
Ste 7
Detroit, MI 48235
Phone (313) 966-3300

20905 Greenfield Rd
Ste 502
Southfield, MI 48075
Phone (248) 395-2888

20905 Greenfield Rd
Ste 205
Southfield, MI 48075
Phone (248) 395-2888

Interoperability endpoints

  • Direct secure messaging: smendiratta1141299@direct.hfhs.org
  • Direct secure messaging: smendira@direct.dmc.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398988800000",
    "number": "1003847617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20905 GREENFIELD RD",
            "address_2": "SUITE 502",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755360",
            "telephone_number": "248-395-2888",
            "fax_number": "248-395-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20905 GREENFIELD RD",
            "address_2": "SUITE 502",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755360",
            "telephone_number": "248-395-2888",
            "fax_number": "248-395-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIRATTA",
        "first_name": "SURINDER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2014-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301060904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4299782",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SURINDER",
            "last_name": "MENDIRATTA",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.