Individual provider Active NPI

Sophia K. Arunselvan, M.D.

  • Nephrology Physician
  • Dearborn, MI
National Provider Identifier
1194930776
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301084038 Issued in MI
Practice address
1611 Monroe St
Dearborn, MI 48124-2912
Phone
(248) 808-5721
NPI assigned
May 14, 2007
Last updated
Jan 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301084038 MI
Nephrology Physician 207RN0300X 4301084038 MI Primary

Addresses

Primary practice location

1611 Monroe St
Dearborn, MI 48124-2912

Mailing address

27906 Western Golf Dr.
Livonia, MI 48154
Phone (734) 421-0436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20080827000301 MI Practitioner - Internal Medicine 5193891109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14555 Levan Rd
Suite 308
Livonia, MI 48154-5085
Phone (734) 288-3370

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comorin Kidneycare PLLC Nephrology CurrentSince Jan 16, 2014 Accepting new patients

Locations

1611 Monroe St
Dearborn, MI 48124
Phone (313) 254-4039

14555 Levan Rd
Ste 308
Livonia, MI 48154
Phone (734) 288-3370

14555 Levan Rd
Ste 403
Livonia, MI 48154
Phone (734) 462-4000

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

Hospital & facility affiliations 3

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1194930776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27906 WESTERN GOLF DR.",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48154",
            "telephone_number": "734-421-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242912",
            "telephone_number": "248-808-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARUNSELVAN",
        "first_name": "SOPHIA",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301084038",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301084038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.