Surendra Kaul, M.D.

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

4301039896 Issued in MI

Practice address

555 W Wackerly St
Suite 3625
Midland, MI 48640-4710

Phone

(989) 835-8625

Fax

(989) 839-8864

NPI assigned

Jul 14, 2005

Sex

Male

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 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Mymichigan Medical Center Midland

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1205889490
  Medicare reassignment
• Mymichigan Medical Center Midland

  • Neuromusculoskeletal Medicine & OMM Physician
  • Midland, MI
  • NPI 1982731659
  NPD

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1225036031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W WACKERLY ST",
            "address_2": "SUITE 3625",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404710",
            "telephone_number": "989-835-8625",
            "fax_number": "989-839-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W WACKERLY ST",
            "address_2": "SUITE 3625",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404710",
            "telephone_number": "989-835-8625",
            "fax_number": "989-839-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUL",
        "first_name": "SURENDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MI",
            "license": "4301039896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1384422",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kanwaldeep Kaur Kapoor
• Karl M Hogue DDS
• Kathalina Goniea MSW LMSW PC
• Kathryn Winkel, DDS PLC
• Carol Kauffman, LMSW
• Bhupinder Kaur
• Mallory Kautz, MA
• Foaz Kayali, MD
• Michael Lee Keck
• Joseph T Keckeisen

• Neurology with Special Qualifications in Child Neurology Physician in Midland, MI
• Providers in Midland, MI by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.