Active NPI
Padma Surapaneni, M.D.
- Psychiatry Physician
- Wayne, MI
National Provider Identifier
1164603817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301064385
- Practice address
- 33101 Annapolis St
Wayne, MI 48184-2405 - Phone
- (734) 721-0200
- Fax
- (734) 721-2008
- NPI assigned
- Nov 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4301064385 | MI | Primary |
Addresses
Primary practice location
33101 Annapolis St
Wayne, MI 48184-2405
Mailing address
33101 Annapolis St
Wayne, MI 48184-2405
Phone (734) 721-0200
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hegira Health, Inc. | Past | Accepting new patients |
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.
-
- Primary Care Clinic/Center
- Westland, MI
- NPI 1477141356
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222646400000",
"number": "1164603817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33101 ANNAPOLIS ST",
"city": "WAYNE",
"state": "MI",
"postal_code": "481842405",
"telephone_number": "734-721-0200",
"fax_number": "734-721-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33101 ANNAPOLIS ST",
"city": "WAYNE",
"state": "MI",
"postal_code": "481842405",
"telephone_number": "734-721-0200",
"fax_number": "734-721-2008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURAPANENI",
"first_name": "PADMA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-23",
"last_updated": "2008-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301064385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayne, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.