Individual provider Active NPI

Kristoffer Bradley Sugg, MD, PHD

  • Plastic and Reconstructive Surgery Physician
  • Sylvania, OH
National Provider Identifier
1104029693
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
35.146320 Issued in OH
Practice address
5308 Harroun Rd Ste 280
Sylvania, OH 43560-2190
Phone
(567) 585-2080
Fax
(567) 585-2081
NPI assigned
Jun 11, 2007
Last updated
Mar 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 35.146320 OH Primary
Plastic and Reconstructive Surgery Physician 2086S0122X 4301090323 MI

Addresses

Primary practice location

5308 Harroun Rd Ste 280
Sylvania, OH 43560-2190

Mailing address

5308 Harroun Rd Ste 280
Sylvania, OH 43560-2190

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ksugg252350@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130723000057 MI Practitioner - Plastic and Reconstructive SurgeryPractitioner - General SurgeryPractitioner - Emergency Medicine 7810138591 Reassigns benefits to 2 organizations
I20230203002466 OH Practitioner - Plastic and Reconstructive Surgery 7810138591 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Wayne State University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Multi Specialty PhysiciansGroup PAC ID 7113182809, 269 clinicians
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-1111

5700 Monroe St
Sylvania, OH 43560-2767
Phone (567) 585-0005

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy22
Melanoma (skin cancer) excision49
Removal of tissue32
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Surgery CurrentSince Jan 1, 2023 Accepting new patients
Iha Health Services Corporation Plastic and Reconstructive Surgery CurrentSince Apr 1, 2020 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
W.a. Foote Memorial Hospital CurrentSince Aug 1, 2020 Accepting new patients
Promedica Central Physicians CurrentSince Jan 1, 2023 Accepting new patients
W. a. Foote Memorial Hospital Current Accepting new patients
W.a. Foote Memorial Hospital Plastic and Reconstructive Surgery CurrentSince Aug 1, 2020 Accepting new patients
Iha Health Service Corporation CurrentSince Apr 1, 2020 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
The Toledo Hospital Past Accepting new patients
First Choice Urgent Care PC Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 647-5871

2305 Genoa Business Park Dr
Ste 120
Brighton, MI 48114
Phone (810) 494-6881

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

49650 Cherry Hill Rd
Ste 220
Canton, MI 48187
Phone (734) 398-7888

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

5308 Harroun Rd
Ste 280
Sylvania, OH 43560
Phone (567) 585-2080

5700 Monroe St
Sylvania, OH 43560
Phone (419) 473-6622

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

7634 W Central Ave
Toledo, OH 43617
Phone (419) 841-2303

Interoperability endpoints

  • Direct secure messaging: ksugg252350@epicdirect.promedica.org
  • Direct secure messaging: ksugg47234@direct.med.umich.edu
  • Direct secure messaging: ksugg695328@direct.hfhs.org

Organizations & group practices 12

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 3

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": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1104029693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5308 HARROUN RD STE 280",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5308 HARROUN RD STE 280",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602190",
            "telephone_number": "567-585-2080",
            "fax_number": "567-585-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGG",
        "first_name": "KRISTOFFER",
        "middle_name": "BRADLEY",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "OH",
            "license": "35.146320",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MI",
            "license": "4301090323",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksugg252350@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "5308 Harroun Rd Ste 280",
            "city": "Sylvania",
            "state": "OH",
            "country_code": "US",
            "postal_code": "435602190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.