Individual provider Active NPI

Satish R Khanzode, M.D.

  • Family Medicine Physician
  • Detroit, MI
National Provider Identifier
1275505695
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301062464 Issued in MI
Practice address
20720 Plymouth Rd
Detroit, MI 48228-1275
Phone
(313) 493-4330
Fax
(313) 493-4419
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301062464 MI Primary

Addresses

Primary practice location

20720 Plymouth Rd
Detroit, MI 48228-1275

Mailing address

27774 Franklin Rd
Southfield, MI 48034-2352
Phone (248) 356-5555

Other identifiers 1

IdentifierTypeStateIssuer
4600389-10MedicaidMI

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
I20040226000473 MI Practitioner - Family PracticePractitioner - Internal Medicine 0840186060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VPS of Mi PLLCGroup PAC ID 1052603297, 4 clinicians

Practice addresses (Care Compare)

25880 Outer Dr
Lincoln Park, MI 48146-1553
Phone (313) 389-5200

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
VPS of Mi PLLC Family Medicine CurrentSince Jun 25, 2020 Accepting new patients
University Family Physicians Family Medicine Past Accepting new patients
Harsha P Jayatilake MD PLLC Past Accepting new patients
Southgate Urgent Care PC PastSince Oct 22, 2023 Accepting new patients
Warren Urgent Care PC PastSince Oct 22, 2023 Accepting new patients

Locations

14825 W McNichols Rd
Detroit, MI 48235
Phone (313) 838-7900

31500 W 13 Mile Rd
Ste 100
Farmington Hills, MI 48334
Phone (248) 509-4070

25880 Outer Dr
Lincoln Park, MI 48146
Phone (313) 294-9410

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1275505695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27774 FRANKLIN RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480342352",
            "telephone_number": "248-356-5555",
            "fax_number": "248-356-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20720 PLYMOUTH RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482281275",
            "telephone_number": "313-493-4330",
            "fax_number": "313-493-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANZODE",
        "first_name": "SATISH",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301062464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4600389-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.