Individual provider Active NPI

Sandhya Sureddi, MD

  • Internal Medicine Physician
  • South Milwaukee, WI
National Provider Identifier
1124134655
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
38991-20 Issued in WI
Practice address
3611 S Chicago Ave
South Milwaukee, WI 53172-3738
Phone
(414) 762-7270
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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 38991-20 WI Primary

Addresses

Primary practice location

3611 S Chicago Ave
South Milwaukee, WI 53172-3738

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

902 Milwaukee Avenue
South Milwaukee, WI 53172-2118
Phone (414) 764-4003

Other identifiers 1

IdentifierTypeStateIssuer
32363700MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ssureddi24232@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20050603000879 WI Practitioner - Internal Medicine 8729021472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians
Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians

Practice addresses (Care Compare)

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

3611 S Chicago Ave
S Milwaukee, WI 53172-3738
Phone (414) 762-7270

7200 Washington Ave
Suite 103
Mount Pleasant, WI 53406-6516
Phone (262) 583-0790

7740 S Lovers Lane Rd
Suite 410
Franklin, WI 53132-2211
Phone (419) 221-6717

S74W16775 Janesville Rd
Muskego, WI 53150-7742
Phone (414) 422-4747

Hospital & facility affiliations

  • Aurora at Home Home health agency, Milwaukee, WI, CCN 527001
  • Aurora at Home Hospice, Wauwatosa, WI, CCN 521528
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38991-20WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince Jun 1, 2009 Accepting new patients
Aurora Health Care Metro, Inc. CurrentSince Feb 8, 2016 Accepting new patients
Lakeshore Medical Clinic LTD CurrentSince Jun 1, 2009 Accepting new patients

Locations

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

3611 S Chicago Ave
South Milwaukee, WI 53172
Phone (414) 762-2450

100 15th Ave
Ste 180
South Milwaukee, WI 53172
Phone (414) 768-5430

902 Milwaukee Ave
South Milwaukee, WI 53172
Phone (414) 762-2120

3611 S Chicago Ave
Ste 100
South Milwaukee, WI 53172
Phone (414) 762-7270

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Interoperability endpoints

  • Direct secure messaging: ssureddi24232@direct.myadvocateaurora.org

Organizations & group practices 3

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 6

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1124134655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 S CHICAGO AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531723738",
            "telephone_number": "414-762-7270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "902 Milwaukee Avenue",
            "address_purpose": "LOCATION",
            "city": "South Milwaukee",
            "state": "WI",
            "postal_code": "531722118",
            "country_code": "US",
            "telephone_number": "414-764-4003",
            "fax_number": "414-764-4005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUREDDI",
        "first_name": "SANDHYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "38991-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32363700",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssureddi24232@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "902 Milwaukee Avenue",
            "city": "South Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531722118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "902 Milwaukee Avenue",
            "city": "South Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531722118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.