Suraya Chamseddine

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704349571 Issued in MI

Practice address

28080 Grand River Ave Ste 208N
Farmington Hills, MI 48336-5966

Phone

(248) 308-2604

Fax

(248) 308-2608

NPI assigned

Apr 25, 2022

Last updated

Oct 10, 2022By 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 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bruce a Cassidy DO PCGroup PAC ID 6709869365, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

74.3 of 100Reported as group

Quality

25

Improvement activities

40

Cost

81.01

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bruce a. Cassidy, D.O., PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1053409268
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1285378422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28080 GRAND RIVER AVE STE 208N",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28080 GRAND RIVER AVE STE 208N",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365966",
            "telephone_number": "248-308-2604",
            "fax_number": "248-308-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMSEDDINE",
        "first_name": "SURAYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-10-10",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704349571",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704349571",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cayla Champion
• Destinee Champion
• Japaris Champion
• Laneesa Champion
• Joshua Champlin
• Amanda Chan
• Eleanor Yuk-Yin Chan, MD, FRCSC
• Kailing Chan, N.P.
• Liezl Chan
• Michael Chan

• Nurse Practitioner in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.