Organization Active NPI

Suha Kassab DPM PC

  • Podiatrist
  • Bloomfield Hills, MI
National Provider Identifier
1316767403
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
SUHA KASSAB DPM PC
Practice address
10 W Square Lake Rd Ste 300
Bloomfield Hills, MI 48302-0468
Phone
(248) 333-4900
Fax
(248) 333-4905
NPI assigned
Oct 14, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Cathy Cabanaw
Title
Practice Manager
Phone
(248) 333-4900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

10 W Square Lake Rd Ste 300
Bloomfield Hills, MI 48302-0468

Mailing address

10 W Square Lake Rd Ste 300
Bloomfield Hills, MI 48302-0468
Phone (248) 333-4900

Other practice location 1

2035 Monroe St
Dearborn, MI 48124-2920
Phone (313) 351-9152

Other identifiers 1

IdentifierTypeStateIssuer
5287600001OtherMIDME PTAN NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Suha Kassab DPM PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1316767403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 W SQUARE LAKE RD STE 300",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020468",
            "telephone_number": "248-333-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W SQUARE LAKE RD STE 300",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020468",
            "telephone_number": "248-333-4900",
            "fax_number": "248-333-4905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2035 Monroe St",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481242920",
            "country_code": "US",
            "telephone_number": "313-351-9152",
            "fax_number": "248-333-4905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUHA KASSAB DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "CABANAW",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "248-333-4900"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PTAN NUMBER",
            "identifier": "5287600001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.