Nayana Sasidharan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301518632 Issued in MI

Practice address

5701 Bow Pointe Dr Ste 100
Clarkston, MI 48346-3199

Phone

(248) 625-2621

Fax

(248) 625-2622

NPI assigned

Jul 5, 2023

Last updated

Oct 28, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793145600000",
    "number": "1194403758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR STE 100",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463199",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR STE 100",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463199",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SASIDHARAN",
        "first_name": "NAYANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2026-10-28",
        "certification_date": "2026-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301518632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.