Active NPI
Samira Sugule, MD
- Internal Medicine Physician
- Blaine, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 71169
- Practice address
- 10961 Club West Pkwy
Blaine, MN 55449-5866 - Phone
- (763) 528-2987
- NPI assigned
- Mar 27, 2019
- Last updated
- Oct 13, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 71169 | CT | Primary |
| Hospitalist Physician | 208M00000X | 71169 | CT |
Addresses
Primary practice location
10961 Club West Pkwy
Blaine, MN 55449-5866
Mailing address
1700 University Ave W
Saint Paul, MN 55104-3727
Other practice location 1
34 Maple St
Norwalk, CT 06850-3815
Phone (203) 852-2025
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10961 Club W Pkwy
Blaine, MN 55449-5866
Phone (763) 572-5700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71169 | CT | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Clinics | Past | Accepting new patients |
Locations
1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860
10961 Club West Pkwy
Minneapolis, MN 55449
Phone (763) 572-5700
1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740
Organizations & group practices 4
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.
-
dba Fairview Clinics-Hiawatha
- Primary Care Clinic/Center
- Minneapolis, MN
- NPI 1346432218
-
dba M Health Fairview Clinic - Elk River
- Primary Care Clinic/Center
- Elk River, MN
- NPI 1144474305
-
- Primary Care Clinic/Center
- Saint Paul, MN
- NPI 1396552147
-
dba Fairview Clinics-New Brighton
- Primary Care Clinic/Center
- New Brighton, MN
- NPI 1881673002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760313600000",
"number": "1235690611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 UNIVERSITY AVE W",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551043727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10961 CLUB WEST PKWY",
"city": "BLAINE",
"state": "MN",
"postal_code": "554495866",
"telephone_number": "763-528-2987"
}
],
"practiceLocations": [
{
"address_1": "34 Maple St",
"address_purpose": "LOCATION",
"city": "Norwalk",
"state": "CT",
"postal_code": "068503815",
"country_code": "US",
"telephone_number": "203-852-2025",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUGULE",
"first_name": "SAMIRA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-27",
"last_updated": "2025-10-13",
"certification_date": "2025-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "71169",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "CT",
"license": "71169",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Blaine, MN
- Kimberly Stubblefield, MA, LPCC
- Ann Studniski
- Jeffrey Michael Styba, D.C.
- Success Arena Home Health and Social Services (Success Arena Home Health)
- Success Arena Home Health and Social Services
- Lynn Alan Sulerud, O.D.
- Summit Orthopedics, LTD
- Superior Medical Services Inc
- Supervalu Pharmacies Inc (Cub Pharmacy)
- Supervalu Pharmacies Inc (Cub Pharmacy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; 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.