Individual provider Active NPI

Sugandhi Sridharan, MD

  • Neurology Physician
  • Kalamazoo, MI
National Provider Identifier
1033173794
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
4301084666 Issued in MI
Practice address
1541 Gull Rd
Suite 100
Kalamazoo, MI 49048-1639
Phone
(269) 381-7380
Fax
(269) 341-4562
NPI assigned
Apr 12, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 4301084666 MI Primary

Addresses

Primary practice location

1541 Gull Rd
Suite 100
Kalamazoo, MI 49048-1639

Mailing address

1541 Gull Rd
Suite 100
Kalamazoo, MI 49048-1639
Phone (269) 381-7380

Other identifiers 1

IdentifierTypeStateIssuer
4778322MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050830000429 MI Practitioner - Neurology 8628009529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 226-5165

1541 Gull Rd
Suite 100
Kalamazoo, MI 49048-1645
Phone (269) 226-5290

3035 Capital Ave SW
Battle Creek, MI 49015-4334

7901 Angling Rd
Portage, MI 49024-0714

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301084666MIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promed Healthcare CurrentSince Feb 1, 2009 Accepting new patients
Beacon Medical Group Michigan Inc Current Accepting new patients
Beacon Kalamazoo Inc CurrentSince Feb 7, 2007 Accepting new patients
Beacon Kalamazoo Inc Current Accepting new patients
Beacon Medical Group Michigan Inc CurrentSince Feb 1, 2009 Accepting new patients
Beacon Kalamazoo Inc CurrentSince Feb 7, 2007 Accepting new patients

Locations

3035 Capital Ave SW
Battle Creek, MI 49015
Phone (269) 565-9100

1541 Gull Rd
Kalamazoo, MI 49048
Phone (269) 343-1264

1541 Gull Rd
Ste 100
Kalamazoo, MI 49048
Phone (269) 226-5290

1717 Shaffer St
Ste 229
Kalamazoo, MI 49048
Phone (269) 381-0764

3025 Gull Rd
Kalamazoo, MI 49048
Phone (269) 343-1264

215 E Mansion St
Ste 1H
Marshall, MI 49068
Phone (269) 789-0025

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Organizations & group practices 6

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

Hospital & facility affiliations 4

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1033173794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 GULL RD",
            "address_2": "SUITE 100",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481639",
            "telephone_number": "269-381-7380",
            "fax_number": "269-341-4562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 GULL RD",
            "address_2": "SUITE 100",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481639",
            "telephone_number": "269-381-7380",
            "fax_number": "269-341-4562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIDHARAN",
        "first_name": "SUGANDHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301084666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4778322",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.