NPIMap

Individual provider Active NPI

Sudhanshu Patel, MD

  • Gastroenterology Physician
  • St Clair Shores, MI
National Provider Identifier
1104816370
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
4301050236 Issued in MI
Practice address
28963 Little Mack Ave
Suite 101
St Clair Shores, MI 48081-3015
Phone
(586) 447-0700
Fax
(586) 498-0707
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 4301050236 MI Primary

Addresses

Primary practice location

28963 Little Mack Ave
Suite 101
St Clair Shores, MI 48081-3015

Mailing address

28963 Little Mack Ave Ste 101
Saint Clair Shores, MI 48081-3017
Phone (586) 447-0700

Other identifiers 4

IdentifierTypeStateIssuer
2383402001OtherCIGNA
5863128OtherAETNA
2666229-10MedicaidMI
P51267OtherBCN

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
I20100814000045 MI Practitioner - Gastroenterology 7113909060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Wayne State University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gi Medical Assoc PCGroup PAC ID 3375525215, 11 clinicians

Practice addresses (Care Compare)

28963 Little Mack Ave
Suite 101
Saint Clair Shores, MI 48081-3017
Phone (586) 447-0700

Hospital & facility affiliations

  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Merit-based Incentive Payment System (MIPS)

Final score
92.49 of 100Reported as group
Quality
91.96
Promoting interoperability
100
Improvement activities
40
Cost
78.54

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy175
Upper gastrointestinal (GI) endoscopy for acid reflux114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301050236MIMDGastroenterology Physician

Interoperability endpoints

  • Direct secure messaging: spatel63457@direct.hfhs.org

Organizations & group practices 1

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 7

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1104816370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28963 LITTLE MACK AVE STE 101",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813017",
            "telephone_number": "586-447-0700",
            "fax_number": "586-447-0795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28963 LITTLE MACK AVE",
            "address_2": "SUITE 101",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813015",
            "telephone_number": "586-447-0700",
            "fax_number": "586-498-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SUDHANSHU",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301050236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2383402001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5863128",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2666229-10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "P51267",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.