Active NPI
Sushila S Rao
- Pediatrics Physician
- Big Rapids, MI
National Provider Identifier
1104819085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301060779
- Practice address
- 650 Linden St
Suite 4
Big Rapids, MI 49307-1879 - Phone
- (231) 796-4470
- Fax
- (231) 796-1605
- NPI assigned
- Aug 25, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301060779 | MI | Primary |
Addresses
Primary practice location
650 Linden St
Suite 4
Big Rapids, MI 49307-1879
Mailing address
650 Linden St
Suite 4
Big Rapids, MI 49307-1879
Phone (231) 796-4470
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3257456 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301060779 | MI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Associates of Big Rapids, P.C. | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GHEFBA/Endpoint/GHEFBA
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.
-
- Pediatrics Physician
- Big Rapids, MI
- NPI 1508999624
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1104819085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 LINDEN ST",
"address_2": "SUITE 4",
"city": "BIG RAPIDS",
"state": "MI",
"postal_code": "493071879",
"telephone_number": "231-796-4470",
"fax_number": "231-796-1605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 LINDEN ST",
"address_2": "SUITE 4",
"city": "BIG RAPIDS",
"state": "MI",
"postal_code": "493071879",
"telephone_number": "231-796-4470",
"fax_number": "231-796-1605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAO",
"first_name": "SUSHILA",
"middle_name": "S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-25",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301060779",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3257456",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Big Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.