NPIMap

Individual provider Active NPI

Edward L Sutherland, MD

  • Diagnostic Radiology Physician
  • Toledo, OH
National Provider Identifier
1154770212
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301502493 Issued in MI
Practice address
5757 Park Center CT.
Toledo, OH 43615
Phone
(419) 474-4064
Fax
(419) 472-2772
NPI assigned
Jun 9, 2016
Last updated
Aug 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301502493 MI Primary

Addresses

Primary practice location

5757 Park Center CT.
Toledo, OH 43615

Mailing address

5757 Park Center CT.
Toledo, OH 43615
Phone (419) 474-4064

Other practice location 1

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210514002323 MI Practitioner - Diagnostic Radiology 7911291166 Reassigns benefits to 2 organizations
I20210716001871 OH Practitioner - Diagnostic Radiology 7911291166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Oakland Univ, William Beaumont School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Toledo Radiological Associates IncGroup PAC ID 2567367519, 51 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (317) 614-9881

274 E Chicago St
Coldwater, MI 49036-2041
Phone (517) 279-5400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
90
Improvement activities
40
Cost
75.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301502493MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Radiology Consultants P.C. Diagnostic Radiology CurrentSince Jul 1, 2026 Accepting new patients

Locations

274 E Chicago St
Coldwater, MI 49036
Phone (517) 279-5400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1154770212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 PARK CENTER CT.",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43615",
            "telephone_number": "419-474-4064",
            "fax_number": "419-472-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 PARK CENTER CT.",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43615",
            "telephone_number": "419-474-4064",
            "fax_number": "419-472-2772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-898-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "EDWARD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-09",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301502493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.