Surayya Soares, M.D.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

4301060351 Issued in MI

Practice address

15200 Kercheval St
Grosse Pointe Park, MI 48230-1356

Phone

(313) 417-6100

Fax

(313) 417-6107

NPI assigned

Aug 15, 2005

Sex

Female

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: ssoares22328@direct.beaumont.edu

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1316949852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 KERCHEVAL ST",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301356",
            "telephone_number": "313-417-6100",
            "fax_number": "313-417-6107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOARES",
        "first_name": "SURAYYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "4301060351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3517340",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssoares22328@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "15200 Kercheval St",
            "city": "Grosse Pointe Park",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482301356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robina Ijaz Sial, M.D.
• Robert James Sisler, MSW
• Lindsay Marie Smith, MD MPH
• Anna Smolinski, LLMSW
• Prakash M Soares, M.D.
• Speech With Sara LLC
• Monique Terese Spurlock
• Carly Steiner, M.ED, BCBA
• Jacqueline Ann Stoey
• Stop the Rumble

• Rheumatology Physician in Grosse Pointe Park, MI
• Providers in Grosse Pointe Park, MI by specialty
• Rheumatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.