Individual provider Active NPI

Suman Gauresh Kashyap, MD

  • Internal Medicine Physician
  • East Lansing, MI
National Provider Identifier
1174534283
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301042427 Issued in MI
Practice address
East Circle Dr
Olin Health Ctr
East Lansing, MI 48824
Phone
(517) 355-4510
Fax
(517) 432-9528
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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 4301042427 MI Primary

Addresses

Primary practice location

East Circle Dr
Olin Health Ctr
East Lansing, MI 48824

Mailing address

Olin Health Center
East Circle Drive
East Lansing, MI 48824-1037
Phone (517) 884-6546

Other identifiers 1

IdentifierTypeStateIssuer
1413210MedicaidMI

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

State licenses

LicenseStateTypeSpecialty
4301042427MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan State University 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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1174534283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "OLIN HEALTH CENTER",
            "address_2": "EAST CIRCLE DRIVE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488241037",
            "telephone_number": "517-884-6546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EAST CIRCLE DR",
            "address_2": "OLIN HEALTH CTR",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "48824",
            "telephone_number": "517-355-4510",
            "fax_number": "517-432-9528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASHYAP",
        "first_name": "SUMAN",
        "middle_name": "GAURESH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301042427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1413210",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.