Dipa Suman Patel, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

4301067695 Issued in MI

Practice address

555 Midtowne St NE
Suite 301
Grand Rapids, MI 49503-5729

Phone

(616) 248-8864

Fax

(616) 248-8874

NPI assigned

Jul 26, 2005

Last updated

Mar 18, 2024By 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

Other identifiers 2

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

Specialty

Dermatology

Education

Wayne State University School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology at Midtowne PCGroup PAC ID 9436304516, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Dermatology at Midtowne, PC

  • Dermatology Physician
  • Grand Rapids, MI
  • NPI 1780933432
  Medicare reassignment Care Compare group Authorized official
• Dermatology Center of Grand Rapids PC

  • Dermatology Physician
  • Grand Rapids, MI
  • NPI 1275527053
  NPD
• El Tal MD PC

  • MOHS-Micrographic Surgery Physician
  • Grand Rapids, MI
  • NPI 1003290750
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Mercy Hospital

  dba Trinity Heath Ann Arbor Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1205836962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 MIDTOWNE ST NE",
            "address_2": "SUITE 301",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035729",
            "telephone_number": "616-248-8864",
            "fax_number": "616-248-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MIDTOWNE ST NE",
            "address_2": "SUITE 301",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035729",
            "telephone_number": "616-248-8864",
            "fax_number": "616-248-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DIPA",
        "middle_name": "SUMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301067695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4217043",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4687596",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bijal Patel, PA
• Bindi Patel, MD
• Chandni Kanti Patel, DDS
• Chirag Patel, M.D.
• Dhaval D Patel, MD
• Divya Patel, DO
• Gaurav Patel, MD
• Hasmukh I Patel, MD
• Heenashree I Patel, PA
• Hetal Patel

• Dermatology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.