NPIMap

Individual provider Active NPI

Suresh K Didwania, M.D.

  • Internal Medicine Physician
  • Winter Garden, FL
National Provider Identifier
1093777880
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036093263 Issued in FL
Practice address
13275 W Colonial Dr
Winter Garden, FL 34787-3984
Phone
(407) 905-8827
Fax
(407) 660-1667
NPI assigned
Apr 5, 2006
Last updated
Jul 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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 036093263 FL Primary

Addresses

Primary practice location

13275 W Colonial Dr
Winter Garden, FL 34787-3984

Mailing address

110 S Woodland St
Winter Garden, FL 34787-3546
Phone (407) 905-8827

Other identifiers 2

IdentifierTypeStateIssuer
202872416OtherILTAX ID
036093263MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20050912001262 IL Practitioner - Internal Medicine 8527099795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Healthcare Illinois Medical Group LLCGroup PAC ID 5597275685, 278 clinicians

Practice addresses (Care Compare)

100 N River Rd
Des Plaines, IL 60016-1209
Phone (847) 297-1800

100 Provena Way
Suite 103
Bourbonnais, IL 60914-4797
Phone (815) 937-8780

500 W Court St
Kankakee, IL 60901-3661
Phone (815) 937-2400

555 W Court St
Suite 406
Kankakee, IL 60901-3675
Phone (815) 932-7474

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10518RLAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Partnership of Illinois Current Accepting new patients
Community Health Partnership of Illinois CurrentSince Jan 1, 2015 Accepting new patients
Prime Healthcare Illinois Medical Group LLC Internal Medicine CurrentSince Jun 15, 2025 Accepting new patients
Community Health Partnership of Illinois CurrentSince Jan 1, 2015 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1801 W Olympic Blvd
#2636
Pasadena, CA 91199

157 S Lincoln Ave
Ste D
Aurora, IL 60505
Phone (630) 859-0015

1325 N Highland Ave
Aurora, IL 60506
Phone (630) 801-2756

100 Provena Way
Ste 103
Bourbonnais, IL 60914
Phone (815) 937-8780

205 W Randolph St
Ste 2222
Chicago, IL 60606
Phone (312) 795-0000

100 N River Rd
Des Plaines, IL 60016
Phone (847) 297-1800

201 N Hammes Ave
Joliet, IL 60435
Phone (224) 273-6350

555 W Court St
Ste 400
Kankakee, IL 60901
Phone (815) 932-4614

202 N Schuyler Ave
Ste 206
Kankakee, IL 60901
Phone (312) 795-0000

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Arc at KankakeeKankakee, IL, CCN 146056 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2025
Oct 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 11

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1093777880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S WOODLAND ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873546",
            "telephone_number": "407-905-8827",
            "fax_number": "321-331-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13275 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873984",
            "telephone_number": "407-905-8827",
            "fax_number": "407-660-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIDWANIA",
        "first_name": "SURESH",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "036093263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "202872416",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093263",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.