Michael V Persaud, DO

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

01980 Issued in IA

Practice address

101 Tower Rd
Suite 105
Dakota Dunes, SD 57049

Phone

(712) 255-1414

NPI assigned

Apr 10, 2006

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 IA, SD2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1235192402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 TOWER RD",
            "address_2": "SUITE 105",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "57049",
            "telephone_number": "712-255-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 TOWER RD",
            "address_2": "SUITE 105",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "57049",
            "telephone_number": "712-255-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSAUD",
        "first_name": "MICHAEL",
        "middle_name": "V",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "01980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0223974",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Dakota Dunes, SD
• Providers in Dakota Dunes, SD by specialty
• Gastroenterology Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.